Presentation is loading. Please wait.

Presentation is loading. Please wait.

1 Epidemiology of Pediatric Tuberculosis in the United States, 1993–2006 Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis.

Published byVivien Webster Modified over 8 years ago

Similar presentations

Presentation on theme: "1 Epidemiology of Pediatric Tuberculosis in the United States, 1993–2006 Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis."— Presentation transcript:

1 1 Epidemiology of Pediatric Tuberculosis in the United States, 1993–2006 Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis Elimination Centers for Disease Control and Prevention (CDC)

2 2 Pediatric TB—Background Definition of pediatric tuberculosis (TB): TB disease in a person <15 years old In 2006, 13,779 TB cases were reported among all age groups 807 (5.9%) were pediatric

3 3 TB Case Definition and Verification Incident case of disease Case verification categories: 1) Laboratory confirmed cases-”Gold Standard” - Positive culture, DNA probe, or nucleic acid amplification test - Positive AFB smear when culture not attainable 2) Clinical case definition - Positive tuberculin skin test - Signs and symptoms of TB disease - Current treatment for TB disease 3) Provider diagnosis: - Diagnosed by health care provider - Does not fulfill all criteria necessary to meet laboratory or clinical case definitions

4 4 TB Cases, All Ages, by Age Group, 1993–2006 Year TB Cases

5 5 TB Case Rates, All Ages, by Age Group 1993–2006 Year TB Case Rate per 100,000 Note: Rates presented on a logarithmic scale

6 6 Percent of Pediatric TB Cases by Age Group 1993–2006 N=15,946

7 7 Pediatric TB Cases by Age Group 1993–2006 N=15,946 Year TB Cases

8 8 TB Case Rates by Pediatric Age Groups 1993–2006 N=15,946 Year TB Case Rate per 100,000 Note: Rates presented on a logarithmic scale

9 9 Pediatric TB Cases by Race/Ethnicity 1993–2006 N=15,946 Year Pediatric TB Cases

10 10 Pediatric TB Case Rates by Race/Ethnicity 1993–2006 N=15,946 TB Case Rate per 100,000 Rates presented on a logarithmic scale. American Indian/Alaska Native rate not shown because of small denominators

11 11 TB Case Rates by Pediatric Age Groups U.S.-born and Foreign-born, 1994–2006 N=14,285 Year TB Case Rate per 100,000 Note: Rates presented on a logarithmic scale. Data not available before 1994. USB = U.S.-born, FB=Foreign-born Foreign-born U.S.-born

12 12 Number and Percent Foreign-born Pediatric TB Cases, 1993–2006 Number of Pediatric TB Cases Percent

13 13 Foreign-born Pediatric TB Cases by Birth Country* and 4-Year Interval, 1995–2006 N=3,231 Mexico (467)Mexico (375)Mexico (323) Philippines (118)Somalia (79)Somalia (65) Viet Nam (73)Philippines (67)Philippines (63) Somalia (43)Haiti (38)Haiti (45) Haiti (39)Viet Nam (36)Viet Nam (37) Russia (38)Sudan (26)India (36) Other (422)Other (417)Other (424) 1995–1998 (n)1999–2002 (n)2003–2006 (n) *Ranked by counts

14 14 States with the Greatest Percent of the National Total Pediatric TB Cases, 1993–2006 N=15,946

15 15 States with Greatest Numbers of Pediatric TB Cases, 1993–2006 *Average percent of total state cases that are pediatric, for all years **Time-averaged annual rate per 100,000 California 4,025 7.7 3.7 Texas 1,874 7.3 2.7 New York 1,399 4.8 2.6 Florida 794 4.4 1.9 Illinois 791 6.9 2.1 Georgia 700 7.8 2.8 All Others 6,363 5.9 1.3 StateNumberPercent*Rate** Pediatric TB Cases Overall U.S.15,9466.31.9

16 16 States with Greatest Percent of Pediatric TB cases, 1993–2006 *Average percent of total state cases that are pediatric, for all years **Time-averaged rate per 100,000 Alaska 125 13.0 5.7 Rhode Island 72 10.4 2.6 Minnesota 253 9.8 1.7 Oklahoma 262 9.8 2.6 Delaware 52 9.7 2.4 Arizona 361 9.3 2.3 All Others 14,821 6.1 1.9 StateNumberPercent*Rate** Pediatric TB Cases Overall U.S.15,9466.31.9

17 17 States with Greatest Rate of Pediatric TB Cases, 1993–2006 *Average percent of total state cases that are pediatric, for all years **Time-averaged rate per 100,000 † D.C. (District of Columbia) is a distinct reporting jurisdiction Alaska 125 13.0 5.7 D.C. † 54 4.0 California 4,025 7.7 3.7 Georgia 700 7.8 2.8 Texas 1,874 7.3 2.7 Arkansas 204 8.2 2.6 All Others 8,964 5.5 1.5 StateNumberPercent*Rate** Pediatric TB Cases Overall U.S.15,946 6.31.9

18 18 Pediatric TB Cases by Case Verification Criterion*, 1993–2006 N=15,946 Provider Diagnosis 24% Clinical Case Definition 51% Laboratory confirmed 25% *Based on the public health surveillance definition for TB [MMWR 1997:46(No. RR-10):40-41]

19 19 Pediatric TB Cases by Case Verification Criterion, 1993–2006 N=15,946 Laboratory Confirmed Clinical Case Provider Diagnosis

20 20 Pediatric TB Cases by Site of Disease, 1993–2006 Any extrapulmonary involvement* (totaling 28.9%) Lymphatic 18.9% Meningeal 3.1% Miliary 1.5% Bone & Joint 1.5% Other 3.9% *Any extrapulmonary involvement which includes cases that are extrapulmonary only and both Patients may have more than one disease site but are counted in mutually exclusive categories for surveillance purposes.

21 21 Percent of Pediatric TB Cases by Site of Disease*, 1993–2006 N=15,946 PulmonaryExtrapulmonaryBoth

22 22 Percent of Pediatric TB Cases with Any Extrapulmonary Involvement* by Age Group and Selected Sites of Disease, 1993–2006 N=15,946 Lymphatic8.019.322.319.2 Meningeal7.53.51.41.8 Miliary5.61.20.61.2 Bone & Joint 0.31.31.72.4 Other3.42.63.98.3 Site of Disease Age < 1 (n=1,471) Age 1-4 (n=7,884) Age 5-9 (n=3,691) Age 10-14 (n=2,900) Total24.827.929.932.9 *Any extrapulmonary involvement includes extrapulmonary only and both Note: Combine the total extrapulmonary percent shown with the pulmonary percent in slide #21 to obtain 100% for each age group.

23 23 Percent of TB Cases in Children Age < 1 Year With Any Extrapulmonary Involvement, 1993–2006 N=1,471 Lymphatic7.2%17.7% Meningeal7.8%3.5% Miliary5.8%3.5% Bone & Joint0.3%0.9% Other3.4%1.8% Site of diseaseU.S.-bornForeign-born Total24.5%*27.4%* *Any extrapulmonary involvement includes extrapulmonary only and both

24 24 Percent of TB Cases in Children Age 1 - 4 Years With Any Extrapulmonary Involvement, 1993–2006 N=7,884 Lymphatic19.4%19.0% Meningeal3.8%2.0% Miliary1.3%1.0% Bone & Joint1.1%2.0% Other2.7%2.0% Site of diseaseU.S.-bornForeign-born Total28.3%*26.0%* *Any Extrapulmonary involvement includes extrapulmonary only and both

25 25 Percent of TB Cases in Children Age 5 - 9 Years With Any Extrapulmonary Involvement, 1993–2006 N=3,691 Lymphatic23.1%20.8% Meningeal1.4%1.0% Miliary0.6% Bone & Joint1.6%2.1% Other4.1%3.8% Site of diseaseU.S.-bornForeign-born Total30.8%*28.3%* *Any Extrapulmonary involvement includes extrapulmonary only and both

26 26 Percent of TB Cases in Children Age 10-14 Years With Any Extrapulmonary Involvement, 1993–2006 N=2,900 Lymphatic20.4%18.1% Meningeal1.6%1.8% Miliary1.5%0.8% Bone & Joint2.0%2.8% Other9.0%7.3% Site of diseaseU.S.-bornForeign-born Total34.5%*30.8%* *Any Extrapulmonary involvement includes extrapulmonary only and both

27 27 Pediatric TB Cases by HIV Status, 1993–2005* N=14,990 Information on HIV result is not available for the majority of pediatric TB cases (80.7%) Percent of pediatric TB cases with HIV-positive test results, minimum estimate** (1.0%) Percent of pediatric cases with HIV-positive test results of those patients with known results (5.1%) *California HIV data through 2004 only **Pediatric TB cases with positive HIV test results divided by all pediatric TB cases. California only reports positive HIV test results based on TB and AIDS registry matching; all other California TB cases are classified as “Unknown.”

28 28 Number and Percent of Culture-confirmed Pediatric TB Cases with Drug Resistance, 1993–2005 First line drugs are Isoniazid, Rifampin, Pyrazinamide and Ethambutol MDR TB = resistance to at least Isoniazid and Rifampin

29 29 Pediatric TB Cases by Use of Directly Observed Therapy (DOT), 1993–2004 N=14,233* Year Percentage *Pediatric TB cases with patient alive at diagnosis and started on treatment

30 30 Pediatric TB Cases by Treatment Outcome 1993–2004 N=14,233* Completed treatment 13,45994.6 Moved 3522.5 Lost to follow-up 1381.0 Died 780.6 Other** 2061.3 Outcome% Note: Cause of death not recorded in TB case reports *Pediatric TB cases with patient alive at diagnosis and started on treatment **Other includes refused, other, unknown and missing Cases

31 31 Deaths Occurring Among Pediatric TB Cases, by Age Group, 1993–2004 N=14,282 Note: Cause of death not recorded in TB case reports **Death includes died during therapy or dead at TB diagnosis Age < 11298262.0 Age 1-47094460.6 Age 5-93334200.6 Age 10-142556200.8 Age Group Cases Deaths** % of Cases

Download ppt "1 Epidemiology of Pediatric Tuberculosis in the United States, 1993–2006 Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis."

Similar presentations

Mortality Among a Tuberculosis Outbreak Los Angeles County, 2007–2013 Brian Baker, MD Amit Chitnis, MD MPH Leslie Henry, BSN RN PHN 48th CTCA Educational.

Mortality Among a Tuberculosis Outbreak Los Angeles County, 2007–2013 Brian Baker, MD Amit Chitnis, MD MPH Leslie Henry, BSN RN PHN 48th CTCA Educational.
World Health Organization TB Case Definitions

World Health Organization TB Case Definitions
World Tuberculosis Day 2015 The TB situation in 2013: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.

World Tuberculosis Day 2015 The TB situation in 2013: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.
TB. Areas of Concern TB cases continue to be reported in every state Drug-resistant cases reported in almost every state Estimated 10-15 million persons.

TB. Areas of Concern TB cases continue to be reported in every state Drug-resistant cases reported in almost every state Estimated million persons.
World Tuberculosis Day 2014 The TB situation in 2012: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.

World Tuberculosis Day 2014 The TB situation in 2012: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.
World Tuberculosis Day 2014 The TB situation in 2012: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.

World Tuberculosis Day 2014 The TB situation in 2012: Findings from the joint TB surveillance and monitoring report by ECDC and the WHO Regional Office.
Diagnosis of TB.

Diagnosis of TB.
Tuberculosis in the UK 2013 report

Tuberculosis in the UK 2013 report
Figure 1. Number of Tuberculosis Cases: California, 1930-2013 California Department of Public Health, Tuberculosis Control Branch Number of Tuberculosis.

Figure 1. Number of Tuberculosis Cases: California, California Department of Public Health, Tuberculosis Control Branch Number of Tuberculosis.
SESSION 1: Introduction to DOT. DOT Curriculum Session 1 2 Worldwide TB Statistics 1.Approximately 8 million new cases of active TB each year 2.World.

SESSION 1: Introduction to DOT. DOT Curriculum Session 1 2 Worldwide TB Statistics 1.Approximately 8 million new cases of active TB each year 2.World.
Global and U.S. Tuberculosis Epidemiology and Principles of Control

Global and U.S. Tuberculosis Epidemiology and Principles of Control
The Changing Landscape of TB: Maryland TB in 2013 Presented by Dr. David Blythe Lisa Paulos, RN MPH, Epidemiologist Center for TB Control & Prevention.

The Changing Landscape of TB: Maryland TB in 2013 Presented by Dr. David Blythe Lisa Paulos, RN MPH, Epidemiologist Center for TB Control & Prevention.
Centers for Disease Control and Prevention CDC Half-Year of Diagnosis** Number of Cases **Adjusted for reporting delay AIDS Cases in Racial/Ethnic Minorities*

Centers for Disease Control and Prevention CDC Half-Year of Diagnosis** Number of Cases **Adjusted for reporting delay AIDS Cases in Racial/Ethnic Minorities*
Division of Tuberculosis Elimination Centers for Disease Control and Prevention Tuberculosis in the United States National Surveillance System Highlights.

Division of Tuberculosis Elimination Centers for Disease Control and Prevention Tuberculosis in the United States National Surveillance System Highlights.
Colorado Department of Public Health and Environment Tuberculosis Prevention and Control Program.

Colorado Department of Public Health and Environment Tuberculosis Prevention and Control Program.
Determination of HIV Infection Among TB Patients in California, 2008 Darryl Kong 1, Jennifer Flood 1, Suzanne Marks 2, James Watt 1 1 California Department.

Determination of HIV Infection Among TB Patients in California, 2008 Darryl Kong 1, Jennifer Flood 1, Suzanne Marks 2, James Watt 1 1 California Department.
Tuberculosis Treatment Completion Among Persons Incarcerated at Diagnosis, U.S. TB Surveillance System, 1999–2008 Kiren Mitruka, MD, MPH (presented on.

Tuberculosis Treatment Completion Among Persons Incarcerated at Diagnosis, U.S. TB Surveillance System, 1999–2008 Kiren Mitruka, MD, MPH (presented on.
Tuberculosis in England 2015 report (presenting data to end of 2014) Tables and figures slide set.

Tuberculosis in England 2015 report (presenting data to end of 2014) Tables and figures slide set.
Directly Observed Therapy  Prescribed by a physician and required by policy for all public and private patients  Strategy to ensure uninterrupted TB.

Directly Observed Therapy  Prescribed by a physician and required by policy for all public and private patients  Strategy to ensure uninterrupted TB.
Division of Tuberculosis Elimination Centers for Disease Control and Prevention Tuberculosis in the United States National Tuberculosis Surveillance System.

Division of Tuberculosis Elimination Centers for Disease Control and Prevention Tuberculosis in the United States National Tuberculosis Surveillance System.

Similar presentations

Ads by Google