TUBERCULOSIS IN ARIZONA A Summary of Cases Reported through December 31, 1999 (06/1/2000) 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, 1990-1999 Arizona 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 1999 262 4,924,350c 5.3 17,528 6.4 Total 2,743 NA NA 228,246 NA (a) Year reported reflects the year a case was counted by ADHS (b) Based on the 1990 Census (c) Based on population projections for the correspondin g year (d) Data from th e U.S. Departmen t of Health and Human Services Demographics Table 2: Tuberculosis Cases and Rates per 100,000 Population by Age Group Arizona, 1999 Table 3: Tuberculosis Cases by Age Group and Sex Arizona, 1999 Age Group Cases Population a Rate per 100,000 Age Group Male Female Total Cases Under 5 7 364,634 1.9 Under 5 3 4 7 5 - 14 2 733,892 0.3 5 - 14 0 2 2 15 - 24 26 672,852 3.9 15 - 24 16 10 26 25 - 44 99 1,475,497 6.7 25 - 44 69 30 99 45 - 64 59 988,913 6.0 45 - 64 47 12 59 Over 64 69 688,562 10.0 Over 64 51 18 69 Total 262 4,924,350 5.3 Total 186 76 262 a Population data published by the ADHS Office of Epidemiology and Statistics (http://www.hs.state.az.us/plan/pop99/ohpes.htm) Table 4: Tuberculosis Cases and Rates per 100,000 Population by Age Group and Race/Ethnicity Age Group Arizona, 1999 White, Non Hispanic African-American Hispanic, White Native American Asian/Pacific Islander # cases # cases # cases # cases # cases Under 5 0 0 5 0 2 5 - 14 0 0 1 1 0 15 - 24 2 3 14 2 5 25 - 44 23 8 50 11 7 45 - 64 24 4 14 16 1 Over 65> 32 0 14 20 3 Total 81 15 98 50 18 1999 Population 3,317,297 176,128 1,060,197 265,195 105,533 Rate per 100,000 2.4 8.5 9.2 18.9 17.1 a Race-specific rates based on Table 10C-1, estimated population by age, gender, race/ethnicity, Arizona,1999 (www.hs.az..us/plan/ohpes.htm) Selected Clinical Characteristics Table 5: Tuberculosis Cases by Form of Disease and Vital Status at Diagnosis Arizona, 1999 Cases Alive at Diagnosis Cases Diagnosed after Death a Total Cases 206 9 215 (82.1%) 19 1 20 (7.6%) Extra-pulmonary Only 26 1 27 (10.3%) Total 251 11 262 Form of Disease Pulmonary Onl y b Pulmonary & Ext ra-pul monary b a It is unknown i f TB was listed as a c ause of death b The classificat ion of Pulmonary TB includes laryngea l TB Table 5 a: Tuberculosis Cases by Verification Criteria, Arizona, 1993-1999 Criteria 1993 1994 1995 1996 1997 1998 1999 Total Clinical 9 22 73 33 32 33 8 210 Culture 219 223 237 232 235 208 232 1586 Provider 0 2 4 16 29 13 21 85 Smear 0 0 3 1 0 0 1 5 Total 228 247 317 282 296 254 262 1886 Table 6: Tuberculosis Cases Resistant to INH and Other Anti-TB Drugs Year Reported Cases Culture Confirmed Drug Sensitivity Testing # ( %) INH Resistant a # (%) b MDR c # (%) b Arizona, 1993 - 1999 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 (5%) 1 (<1%) 14 ( 7%) 25 (12%) 1999 262 231 225 (97%) 7 (3%) 2 (<1%) 26 (12%) 35 (16%) Total 1886 1586 1,498 (94%) 78 ( 5%) 22 ( 2%) 146 (10%) 246 (16%) (a) Resistant to at least INH without resis tanc e to RIF (b) Percent of total cases with sensitivity testing (c) MDR=Resistant to at least INH and RIF (d) Resistance to drugs other than INH Risk Factor Information Table 7: Tuberculosis Cases by Selected Characteristics Arizona, 1994 - 1999 1998 (%) a 1994 (%) a 1995 (%) a 1996 (%) a 1997 (%) a 247 317 282 296 254 262 0 0 0 0 1 (<1%) 0 Health Care Worker 6 (2%) 8 (3%) 2 (1%) 3 (1%) 3 (1%) 1 (<1%) Migrant Farm Worker 7 (3%) 4 (1%) 9 (3%) 2 (1%) 4 (2%) 5 (2%) 4 (2%) 17 (5%) 12 (4%) 11 (4%) 6 (2%) 10 (4%) 5 (2%) 14 (4%) 13 (5%) 17 (6%) 10 (4%) 20 (8%) 28 (11%) 43 (14%) 37 (13%) 45 (15%) 40 (16%) 53 (20%) Long Term Care Facility 10 (4%) 16 (5%) 14 (5%) 12 (4%) 5 (2%) 7 (3%) Correctional Facility 6 (2%) 16 (5%) 18 (6%) 23 (8%) 13 (5%) 18 (7%) 26 (11%) 45 (14%) 35 (12%) 27 (9%) 30 (12%) 36 (14%) 88 (36%) 124 (39%) 108 (38%) 109 (37%) 100 (39%) 109(42%) 14 (6%) 28 (9%) 16 (6%) 12 (4%) 13 (5%) 16 (6%) Risk Factor Total Cases Reported 1999 (%) 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) % of annual cases (b) Within the year before TB diagnosis ( 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, 1999 Years in the United States Before Tuberculosis Report << 2< 2 Years2 -2 - 32 - 3 Years "e4 Years Unknown Total Cases (%) a Asia/Philippines/Pacific Islands 6 3 9 0 18 (16.5%) Mexico 17 19 27 4 67 (61.5%) Central/ South America & Caribbean 2 0 3 0 5 (4.6%) Europe and Former Soviet States 2 1 2 0 5 (4.6%) Africa 6 0 1 0 7 (6.4%) India 0 2 2 1 5 (4.6%) U.S. Territories (Marshall or Virgin Islands) 0 0 2 0 2 (1.8%) Unknown 0 0 0 0 0 Total 33 25 46 5 109 (100%) a Percent of total f oreign-born ca ses County of Residence Table 9: Tuberculosis Cases by County of Residence and Other Selected Characteristics Arizona, 1999 Apache Cochise Coconino Gila Graham Greenlee La Paz Maricopa Mohave Navajo Pima Pinal Santa Cruz Yavapai Yuma Total Cases 11 5 6 5 0 0 3 144 0 10 46 15 0 5 12 262 66,950 124,575 122,825 50,150 35,750 9,225 19,250 2,913,475 142,925 93,400 845,775 165,400 39,100 155,900 139,650 4,924,350 16.4 4.0 4.9 9.9 0 0 15.6 4.9 0 10.7 5.4 9.1 0 3.2 8.6 5.3 White, Not Hispanic 0 5 0 0 0 0 1 52 0 0 19 1 0 2 1 81 Hispanic, W hite 0 0 1 0 0 0 2 57 0 0 17 11 0 3 7 98 African-American 0 0 0 0 0 0 0 11 0 0 3 0 0 0 1 15 Native American 11 0 5 5 0 0 0 11 0 10 4 3 0 0 1 50 Asian/Pacific Islander 0 0 0 0 0 0 0 13 0 0 3 0 0 0 2 18 All Sexes <1 5 years 0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 9 Females,"e 1 5 years 4 0 3 0 0 0 0 46 0 4 8 1 0 2 2 70 7 5 3 5 0 0 3 92 0 6 38 14 0 3 7 183 Correctional Facility 0 0 1 0 0 0 0 5 0 0 3 9 0 0 0 18 Long Term C are Facility 1 0 1 0 0 0 0 3 0 0 2 0 0 0 0 7 0 0 0 2 0 0 0 22 0 0 9 1 0 1 1 36 0 0 1 0 0 0 2 68 0 0 17 8 0 3 10 109 0 1 0 0 0 0 0 4 0 0 1 0 0 0 1 7 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 2 County of Residence Cases Population Rate/100,000 Population a Race/E thnicity Sex/Age "e 1 5 years Males, Type of Residence Homeless b Country o f Birth Foreign-born Drug Resistance INH Resistance c MDR d a b c d Based on population data published by the Office of Epidemiology and Statistics (http://www.hs.state.az.us/plan/ohpes.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: tbes\epidem\1999\99stats.wpd Created by: S.E.Good, Data generated: 15MAR2000 Finalized: 10/02/2000