TUBERCULOSIS IN ARIZONA A Summary of Cases Reported through December 31, 1998 Tuberculosis Control 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 Morbidity Table 1: Tuberculosis Cases and Rates per 100,000 Population Arizona and United States, 1990-1998 Arizona a b c d United States Year Reported a Cases Population Rate per 100,000 Cases d Rate per 100,000 d 1990 275 3,665,228 b 7.5 25,701 10.3 1991 324 3,763,372 c 8.6 26,283 10.4 1992 258 3,858,825 c 6.7 26,673 10.5 1993 228 3,946,975 c 5.8 25,287 9.8 1994 247 4,036,875 c 6.1 24,361 9.4 1995 317 4,184,723 c 7.6 22,860 8.7 1996 282 4,462,717 c 6.3 21,337 8.0 1997 296 4,595,379 c 6.4 19,855 7.4 1998 254 4,722,097 c 5.4 18,361 6.8 Total 2,481 NA NA NA NA Year reported reflects the year a case was counted by ADHS Based on the 1990 Census Based on population projections for the correspon ding years Data from the U .S. Department of Health and Hu man Services Demographics Table 2: Tuberculosis Cases and Rates per 100,000 Population by Age Group Arizona, 1998 Table 3: Tuberculosis Cases by Age Group and Sex Arizona, 1998 Age Group Cases # (%) Population a Rate per 100,000 Age Group Male Female Total Cases Under 5 11 (4.3) 351,612 3.1 Under 5 7 4 11 5 - 14 13 (5.1) 706,235 1.8 5 - 14 5 8 13 15 - 24 21 (8.3) 647,480 3.2 15 - 24 12 9 21 25 - 44 69 (27.2) 1,422,033 4.9 25 - 44 43 26 69 45 - 64 72 (28.3) 934,149 7.7 45 - 64 51 21 72 Over 64 68 (26.8) 660,588 10.3 Over 64 42 26 68 Total 254 (100) 4,722,097 5.4 Total 160 94 254 a Popula tion da ta publ ished by t he ADHS Offi ce of Epid emiology and Statistics (http://www.hs.state.az.us/plan/pop98/po98.htm) Table 4: Tuberculosis Cases and Rates per 100,000 Population by Age Group and Race/Ethnicity Arizona, 1998 Age Group White, Not Hispanic African-American Hispanic, White Native American Asian/Pacific Islander Under 5 2 1 7 1 0 5 - 14 0 1 12 0 0 15 - 24 2 3 12 2 2 25 - 44 16 8 32 7 6 45 - 64 27 2 22 16 5 Over 64 31 2 19 14 2 Total 78 17 104 40 15 1997 Population a 3,072,763 158,423 947,077 251,306 91,158 Rate per 100,000 2.5 10.7 11.0 15.9 16.5 a Race-specific rates based on 1997 data as 1998 data by race/ethnicity were unavailable as of April 16, 1999 (http://www.census.gov/population/www/projections/stproj.htm) Selected Clinical Characteristics Table 5: Tuberculosis Cases by Form of Disease and Vital Status at Diagnosis Arizona, 1998 Cases Alive at Diagnosis Cases Diagnosed after Death a Total Cases 186 6 192 17 0 17 Extra-pulmonary Only 41 4 45 Total 244 10 254 Form of Disease Pulmonary Onl y b Pulmonary & Ext ra-pul monary b a It is unknown if TB was listed as a cause of death b The classific ation of Pulmonary TB includes laryngea l TB Table 6: Tuberculosis Cases Resistant to INH and Other Anti-TB Drugs Year Reported a b c d Cases Culture Confirmed Drug Sensitivity Testing # ( %) INH Resistant a # (%) b MDR c # (%) b Arizona, 1993 - 1998 Other Drug Resistance d # (%) b Total Drug Resistance # (%) b 1993 228 219 193 (88%) 11 ( 6%) 3 ( 2%) 18 ( 9%) 32 (17%) 1994 247 223 204 (91%) 15 ( 7%) 4 ( 2%) 17 ( 8%) 36 (18%) 1995 317 237 231 (97%) 8 ( 3%) 3 ( 1%) 29 (13%) 40 (17%) 1996 282 232 223 (96%) 6 ( 3%) 7 ( 3%) 23 (10%) 36 (16%) 1997 296 235 223 (95%) 18 ( 8%) 2 ( 1%) 18 ( 8%) 38 (17%) 1998 254 208 204 (98%) 10 1 (<1%) 14 Total 1,624 1,354 1,278 (94%) 68 Resistant to at least INH without resis tanc e to RIF Percent of total cases with sensitivity testing Resistant to at least INH an d RIF Resistance to drugs other than INH (5%) ( 5%) 20 ( 2%) 119 ( 7%) ( 9%) 25 207 (12%) (16%) Risk Factor Information Table 7: Tuberculosis Cases by Selected Characteristics Arizona, 1993 - 1998 1993 (%) a 1994 (%) a 1995 (%) a 1996 (%) a 1997 (%) a 1998 (%) a 228 247 317 282 296 254 0 0 0 0 0 1 (<1%) Health Care Worker 3 (1%) 6 (2%) 8 (3%) 2 (1%) 3 (1%) 3 (1%) Migrant Farm Worker 5 (2%) 7 (3%) 4 (1%) 9 (3%) 2 (1%) 4 (2%) 8 (4%) 4 (2%) 17 (5%) 12 (4%) 11 (4%) 6 (2%) 9 (4%) 5 (2%) 14 (4%) 13 (5%) 17 (6%) 10 (4%) 22 (10%) 28 (11%) 43 (14%) 37 (13%) 45 (15%) 40 (16%) Long Term Care Facility 5 (2%) 10 (4%) 16 (5%) 14 (5%) 12 (4%) 5 (2%) Correctional Facility 6 (3%) 6 (2%) 16 (5%) 18 (6%) 23 (8%) 13 (5%) 31 (14%) 26 (11%) 45 (14%) 35 (12%) 27 (9%) 30 (12%) 75 (33%) 88 (36%) 124 (39%) 108 (38%) 109 (37%) 100 (39%) 16 (7%) 14 (6%) 28 (9%) 16 (6%) 12 (4%) 13 (5%) Risk Factor Total Cases Reported Occupation Correctional Facility Worker Reported Behaviors Injectable Drug User Non-injectable Drugs b b Excessive Alcohol Use b Type of Residence Homeless b Country of Birth Foreign Born Underlying Disease Known HIV Infection c a Percent of ann ual cases b Within the year before TB diagnosis (routine collection of information began Jan. 1, 1993) c HIV infection is a reportable condition in Arizona. Table 8: Tuberculosis Cases Among Foreign-born Persons by Length of Time in the United States Area of Origin Arizona, 1998 Years in the United States Before Tuberculosis Report << 2< 2 Years2 - 32 - 3 Years2 "e-4 3Years Years Unknown Total Cases (%) a Asia/Pacific Islands 2 1 10 0 13 (13%) Mexico 16 7 45 1 69 (69%) Other Central/ South America & Caribbean 2 0 4 1 7 ( 7%) Europe and Former Soviet States 2 0 1 0 3 ( 3%) Africa 2 0 2 0 4 ( 4%) India 1 0 2 0 3 ( 3%) Unknown 0 0 1 0 1 ( 1%) Total 25 8 65 2 100 (100%) a Percent of total c ases County of Residence Table 9: Tuberculosis Cases by County of Residence and Other Selected Characteristics Arizona, 1998 Apache Cochise Coconino Gila Graham Greenle e La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total Cases 7 2 4 4 1 1 1 138 6 10 51 7 5 2 15 254 10.6 1.7 3.4 8.5 3.0 11.3 5.2 4.9 4.4 11.5 6.2 4.6 13.6 1.4 11.4 5.4 White, Not Hispanic 0 2 1 1 0 1 0 40 6 0 22 1 0 1 3 78 Hispanic, White 0 0 0 0 0 0 1 68 0 0 16 4 5 1 9 104 African-American 0 0 0 0 0 0 0 13 0 0 4 0 0 0 0 17 Native American 7 0 3 3 1 0 0 4 0 9 9 2 0 0 2 40 Asian/Pacifi c Islander 0 0 0 0 0 0 0 13 0 1 0 0 0 0 1 15 All Sexes <15 years 0 0 0 0 0 0 0 18 1 0 0 0 1 0 4 24 Females,"e 15 years 1 1 3 2 1 0 0 42 1 4 19 1 2 1 4 82 Males, "e 15 years 6 1 1 2 0 1 1 78 4 6 32 6 2 1 7 148 Correcti onal Faci lity 0 0 0 0 0 0 1 7 0 0 1 4 0 0 0 13 Long Term Care Facility 0 0 0 0 0 0 0 3 0 0 1 1 0 0 0 5 Homeless b 0 0 1 0 0 0 0 18 1 1 7 1 0 0 1 30 0 0 0 0 0 0 1 66 1 1 15 4 4 1 7 100 0 0 0 0 0 0 0 6 0 0 4 0 0 0 0 10 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 County of Residence Cases Rate/100,000 Population a Race/Ethnicity Sex/Age Type of Residence Country of Birth Foreign-born Drug Resistance INH Resistance MDR d a b c d c Based on population data published by the Office of Epidemiology and Statistics (http://www.hs.state.az.us/plan/pop98/po98.htm) Within the year before TB diagnosis (routine collection of information began Jan. 1, 1993). Resistance to at least INH without resis tanc e to RIF Res ista nce t o at le ast IN H and RIF File: 98stats.wpd/6May1999/dgm/seg Database: 1998.dbf