TUBERCULOSIS IN ARIZONA A Summary of Cases Reported through December 31, 1997 Report Generated on June 16, 1998 Tuberculosis Elimination Section Office o f Infectiou s Disease S ervices/B ureau o f Epidem iology a nd Disea se Con trol Arizona Department of Health Services Data in this Report are Provisional Morbidity Table 1: Tuberculosis Cases and Case Rates per 100,000 Population: Arizona and United States, 1990-1997 Arizona Year Reported* Cases Case s**** Rate p er 100, 000**** 1990 275 3,665 ,228** 7.5** 25,701 10.3 1991 324 3,763 ,372*** 8.6*** 26,283 10.4 1992 258 3,858 ,825*** 6.7*** 26,673 10.5 1993 228 3,946 ,975*** 5.8*** 25,287 9.8 1994 247 4,036 ,875*** 6.1*** 24,361 9.4 1995 317 4,184 ,723*** 7.6*** 22,860 8.7 1996 282 4,462 ,717*** 6.3*** 21,337 8.0 1997 296 4,595 ,379*** 6.4*** 19,855 7.4 Total 2,227 NA NA NA NA * ** *** **** Population United Stat es Rate per 100,000 Y ear re por te d r e f le c ts the ye a r a c a se wa s counted by A D H S Based on the 199 0 Census Based o n population pro jections for the corre sponding yea rs (February 19 97) Data from the U.S. Department of Health and Human Services Demographics Table 2: Tuberculosis Cases and Case Rates per 100,000 Population by Age Group: Arizona, 1997 Table 3: Tuberculosis Cases by Age Group and Sex: Arizona, 1997 Age Group Cases # ( %) Population* Rate per 100,000* Age Group Male # (%)* (% )** Female # (%)* (% )** Total Cases # (%)* (% )** Under 5 14 ( 4.7) 346,123 4.0 Under 5 6 (42.9) ( 3.3) 8 (57.1) ( 7.0) 14 (100) ( 4.7) 5 - 14 17 ( 5.7) 691,044 2.5 5 - 14 7 (41.2) ( 3.8) 10 (58.8) ( 8.8) 17 (100) ( 5.8) 15 - 24 19 ( 6.4) 628,868 3.0 15 - 24 11 (57.9) ( 6.0) 8 (42.1) ( 7.0) 19 (100) ( 6.4) 25 - 44 96 (32.4) 1,400,869 6.9 25 - 44 68 (70.8) (37.4) 28 (29.2) (24.6) 96 (100) (32.4) 45 - 64 74 (25.0) 889,740 8.3 45 - 64 49 (66.2) (26.9) 25 (33.8) (21.9) 74 (100) (25.0) Over 64 76 (25.7) 638,735 11.9 Over 64 41 (54.0) (22.5) 35 (46.0) (30.7) 76 (100) (25.7) 296 (100) 4,595,379 6.4 Total 182 (61.5) ( 100) 114 (38.5) ( 100) 296 (100) (100) Total * Based on 1997 population projections ( approved by the ADHS Director ,February 1997) * ** Perce ntage o f row to tal Percentage of column total Table 4: Tuberculosis Cases by Age Group and Race/Ethnicity: Arizona, 1997 U n k n ow n Total Cases Hispanic, All Races **** # (%)* (% )** Native American, Not H ispanic **** # (%)* (% )** Asian /Pacific Islander, Not Hispanic # (%)* (% )** # (%)* (% )** # (%)* (% )** 0 10 (71.4) ( 7.7) 1 ( 7.1) ( 2.0) 1 ( 7.1) ( 5.3) 0 14 (100) ( 4.7) 1 ( 5.9) ( 1.1) 0 14 (82.4) (10.8) 1 ( 5.9) ( 2.0) 1 ( 5.9) ( 5.3) 0 17 (100) ( 5.7) 15 - 24 2 (10.5) ( 2.3 ) 0 13 (68.4) (10.0) 2 (10.5) ( 4.1) 2 (10.5) (10.5) 0 19 (100) ( 6.4) 25 - 44 28 (29.2) (32.2) 3 ( 3.1) (27.3) 52 (54.2) (40.0) 7 ( 7.3) (14.3) 6 ( 6.3) (31.6) 0 96 (100) (32.4) 45 - 64 29 (39.2) (33.3) 4 ( 5.4) (36.4) 15 (20.3) (11.5) 20 (27.0) (40.8) 6 ( 8.1) (31.6) 0 74 (100) (25.0) Over 64 25 (32.9) (28.7) 4 ( 5.3) (36.4) 26 (34.2) (20.0) 18 (23.7) (36.7) 3 ( 3.9) ( 15.8) 0 76 (100) (25.7) Total 87 (29.4) (100) 11 ( 3.7) (100) 130 (43.9) ( 100) 49 (16.6) ( 100) 19 (6.4) ( 100) 0 296 (100) (100) 1997 Population 3,072,763 158,423 947,077 251,306 91,158 NA NA Rate/1 00,00 0*** 2.8 6.9 13.7 19.5 20.8 NA NA White, Not Hispa nic ( NH) # (%)* (% )** African-American, Not Hispanic # (%)* (% )** Under 5 2 (14.3) ( 2.3) 5 - 14 Age Group * ** *** **** Percentage of row total Percentage of column total Rates based on 1997 population estimates (due to methological limitations, estimates by race/ethnicity do not total general population projections) T hree ca se s se lf- de sc ribe d Na tive Amer ic an r a c e and H isp a n ic e th n ic ity ( d u e to d e n o m in a to r limita tio n s th e y w er e c la s s ifie d a s N a tive A me r ic a n , N H ) Selected Clinical Characteristics Table 5: Tuberculosis Cases by Form of Disease and Vital Status at Diagnosis: Arizona, 1997 Form of Disease Cases Alive at Diagnosis # (%)* (% )** Case s Diagn osed a fter Dea th*** # (%)* (% )** Total Cases # (%)* (% )** Pulmona ry Only **** 234 (96.3 ) (82.1) 9 ( 3.7) (81.8) P ulmonary & E xtra-pulmona r y (inc lude s miliar y TB) 11 (91.7) ( 3 .9) 1 ( 8.3) ( 9.1) 12 (100) ( 4 .1) Extra- pulmo nary O nly 40 (97.6) (1 4.0) 1 ( 2.4) ( 9.1) 41 (100) (1 3.9) Total 285 (96.3 ) (100) 11 ( 3.7) (10 0) 296 (100 ) (100) * ** *** **** 243 (100 ) (82.1) P e r ce n ta g e by r ow Percentage by column It is unknown if TB was the und erlying cause of de ath The classification of Pulmonary TB includes laryngeal TB Table 6: Tuberculosis Cases Resistant to INH and Other Anti-TB Drugs: Arizona, 1993 - 1997 Year Reported* Cases Number of Culture Confirmed Cases with Initial Drug Sensitivity Test Re sults INH R esistant** Multiple D rug Res istant**** # (%)*** # (%)*** OtherOther D rug Res istance***** Total Cas es with Drug Resistance # (%)*** # (%)*** 1993 228 193 11 ( 5.7) 3 ( 1.6) 17 ( 8.8) 31 (16.1) 1994 247 204 15 ( 7.4) 4 ( 2.0) 17 ( 8.3) 36 (17.6) 1995 317 231 8 ( 3.5) 3 ( 1.3) 29 (12.6) 40 (17.3) 1996 282 223 5 ( 2.2) 7 ( 3.1) 24 (10.8) 36 (16.1) 1997 296 219 18 ( 8.2) 2 ( 0.9) 16 ( 7.3) 36 (16.4) Total 1,370 1,070 57 ( 5.3) 19 ( 1.8) * ** *** **** ***** 103 ( 9.6) 179 (16.7 ) Y ear re por te d r e f le c ts the ye a r a c a se wa s counted by A D H S R esista nt to a t le a st INH without resistance to R IF Percent of total cases with sensitivity testing Resistant to at least INH and RIF Resistance to drugs other than I N H Tuberculosis in Arizona - June 16, 1998 Page 2 Risk Factor Information Table 7: Tuberculosis Cases by Selected Characteristics: Arizona, 1993 - 1997 Risk Factor (RF) 1 9 9 3 Ca s e s w i th R F # (% of all 1993 cases) 1 9 9 4 Ca s e s w i th R F # (% of all 1994 cases) 1 9 9 5 Ca s e s w i th R F # (% of all 1995 cases) 1996 Cases with RF # (% of all 1996 cases) 1997 Cases with RF # (% of all 1997 cases) Occupation Correctional Facility Worker 0 0 0 0 0 Health Care Worke r 3 ( 1.3) 6 ( 2.4) 8 ( 2.5) 2 ( 0.7) 3 ( 1.0) Migrant Farm Worker 5 ( 2.2) 7 ( 2.8) 4 ( 1.3) 9 ( 3.2) 2 ( 0.7) Injectable Dru g User* 8 ( 3.5) 4 ( 1.6) 17 ( 5.4) 12 ( 4.3) 11 ( 3.7) N o n -i n je c t ab l e D r u gs O N L Y * 9 ( 4.0) 5 ( 2.0) 14 ( 4.4) 13 ( 4.6) 17 ( 5.7) 22 ( 9.7) 28 (11.3) 43 (13.6) 37 (13.1) 45 ( 15.2) Long Term C are Facility 5 ( 2.2) 10 ( 4.0) 16 ( 5.0) 15 ( 5.3) 13 ( 4.4) Correctiona l Facility 6 ( 2.6) 6 ( 2.4) 16 ( 5.0) 18 ( 6.4) 23 ( 7.8) 31 (13.6) 26 (10.5) 45 (14.2) 34 (12.1) 25 ( 8.4) 75 (32.9) 88 (35.6) 121 (38.2) 107 (37.9 ) 109 ( 36.8) 16 ( 7.0) 14 ( 5.7) 28 ( 8.8) 16 ( 5.7) 11 ( 3.7) Reported Behaviors Excessive Alcohol Use* Type of Residence Homeless* Country of Birth Foreign Born Underlying Disease Know n HIV/A IDS** * ** Within the year before TB diagnosis (routine collection of information began Jan. 1, 1993) Due to the lag in H IV/AID S reporting, the da ta on HIV /AIDS an d TB co -morbidity may be incomplete Table 8: Tuberculosis Cases Among Foreign-born Persons by Length of Time in the United States: Arizona, 1997 Area of Origin Years in the U nited States Be fore Tubercu losis Report Less than Two Years # (%)* (% )** Two to Three Years # (%)* (% )** Four or M ore # (%)* (% )** Unknown # (%)* (% )** Total Cases # (%)* (% )** Asia/Pacific Islands 3 (13.0) (10.7) 10 (43.5) (23.3) 10 (43.5) (31.3) 0 23 (100) (2 1.1) Mexico 24 (33.3) (85.7) 23 (31.9) (5 3.5) 20 (27.8) (62.5) 5 (7.0) (83.3) 72 (100) (6 6.1) Other Ce ntral and South American Countries 0 3 (50.0) ( 7.0) 2 (33.3) ( 6.2) 1 ( 16.7) (16.7) 6 (100) ( 5.5 ) Europe and the Former Soviet States 1 (16.7) ( 3.6) 5 (83.3) (11.6) 0 0 6 ( 100) ( 5.5) Other 0 2 (100) ( 4.6) 0 0 2 (100) ( 1.8 ) Total 28 (25.7) (100) 32 (29.4) (100) 6 ( 5.5) (100) * ** 43 (39.4) ( 100) 109 (100 ) (100) Percentage of row total Percentage of column total Tuberculosis in Arizona - June 16, 1998 Page 3 County of Residence Table 9: Tuberculosis Cases by County of Residence and Selected Characteristics: Arizona, 1997 Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total Cases 19 6 4 2 3 2 1 165 6 10 38 18 0 2 20 296 29.1 5.1 3.5 4.3 9.3 22.9 5.3 6.1 4.5 11.7 4.8 12.1 0 1.4 15.6 6.4 White, Not Hispanic 0 2 0 1 0 1 1 55 0 0 18 1 0 2 6 87 African-American, Not Hispanic 0 1 0 0 0 0 0 7 0 0 3 0 0 0 0 11 Hispanic, All Races 0 2 0 0 2 1 0 81 5 1 10 15 0 0 13 130 Native American, Not Hispanic 19 0 4 1 1 0 0 9 0 8 5 2 0 0 0 49 Asian/Pacific Islander, Not Hispanic 0 1 0 0 0 0 0 13 1 1 2 0 0 0 1 19 All Sexes, C hildren <= 14 years 1 0 0 0 0 0 0 22 0 1 0 1 0 0 6 31 Females, >1 4 years 9 3 0 0 1 0 0 58 3 3 13 4 0 0 2 96 Males, > 14 years 9 3 4 2 2 2 1 85 3 6 25 13 0 2 12 169 Correctional Facility 0 1 0 1 0 0 0 9 0 1 2 7 0 0 2 23 Long Term C are Facility 2 1 0 0 0 0 0 8 0 0 2 0 0 0 0 13 Home less** 1 0 0 0 0 0 0 15 0 0 6 2 0 0 1 25 0 2 0 0 0 0 0 71 2 1 13 11 0 0 9 109 INH R esistanc e*** 0 1 0 0 0 0 0 11 2 1 1 2 0 0 0 18 MD R**** 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 County of Residence Cases Rate per 100,000 Population* Race/E thnicity Sex/Age Type of Residence Country o f Birth Foreign-born Drug Resistance * ** *** **** Based o n 1997 po pulation projections (August 199 7) Within the year before TB diagnosis. R e s istance to at least INH without resistance to R IF Resistance to at least INH and RIF 0 Docume nt Database Date Author- G:groups\tbes\epidem\1997\97stats.wpd G:\tbes\1997.rec 06/16/98 DGM ***** Three cases self-described Native American Race and Hispanic ethnicity (due to denominator limitations they were classified as Native American, NH) Note: T he data in this rep ort are pro visional. Report approved by OIDS Office Chief on June 16, 1998 Tuberculosis in Arizona - June 16, 1998 Page 4