Tuberculosis decreasing, but rate of decline slows

The tuberculosis in the United States continues to decline, has slowed since 2000 and the rate of infection among racial/ethnic minorities and foreign-born individuals continues to be disproportionately high.

Those were among the findings of a report on 2008 US trends in tuberculosis published by the Centers for Disease Control and Prevention.

In 2008, a total of 12,898 incident TB cases were reported in the United States. Representing a decline of 3.8 percent from 2007 and a rate of 4.2 per 100,000 population.

The 2008 rate was the lowest recorded since TB reporting began in 1953.

Progress has slowed in recent years, however, with the average annual percentage decline in the TB rate decreasing from 7.3 percent per year during 1993-2000 to 3.8 percent during 2000-2008.

Among the 50 states and the District of Columbia, TB rates ranged from a low of 0.5/100,000 in North Dakota to a high of 9.6/100,000 in Hawaii.

California, Florida, New York, and Texas reported more than 500 cases each and together accounted for 49 percent of all TB cases in 2008.

TB rates among Hispanics and blacks were nearly eight times higher than among non-Hispanic whites (8.1 and 8.7 per 100,000, respectively, versus 1.1 per 100,000), while the rate among Asians was nearly 23 times higher than among non-Hispanic whites (25.1 per 100,000).

The report classified persons identified as white, black, Asian, American Indian/Alaska Native, native Hawaiian or other Pacific Islanders or of multiple races, as non-Hispanic. “Persons identified as Hispanic might be of any race,” the report explained.

The 2008 TB rate in foreign-born persons living in the United States was 20.2 per 100,000, 10 times higher than for US-born individuals. People born in Mexico, the Philippines, India, and Vietnam accounted for half of the 7,541 tuberculosis cases in foreign-born persons that year.

However, the rate of TB cases, continued to decline both among foreign-born individuals (down 2.6 percent since 2007), as well as those born in the United States (down 4.7 percent).

Based on the data, the CDC recommended that TB prevention and control capacity be intensified to improve case management and contact investigations. The agency also called for intensified outreach, testing, and treatment of high risk populations; enhanced treatment and diagnostic tools; increased scientific research to be better understand TB transmission; and continued collaboration with other nations to reduce TB globally.