1 / 32

Epidemiology of Pediatric Tuberculosis in the United States, 1993–2012

Epidemiology of Pediatric Tuberculosis in the United States, 1993–2012. Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis Elimination Centers for Disease Control and Prevention (CDC).

nieve
Download Presentation

Epidemiology of Pediatric Tuberculosis in the United States, 1993–2012

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Epidemiology of Pediatric Tuberculosis in the United States, 1993–2012 Surveillance, Epidemiology, and Outbreak Investigations Branch Division of Tuberculosis Elimination Centers for Disease Control and Prevention (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination

  2. Pediatric TB—Background • Definition of pediatric tuberculosis (TB): TB disease in a person < 15 years old • In 2012: • 9,945 TB cases were reported among all age groups • 486 (4.9%) were pediatric

  3. 2009 TB Case Definition and Verification • Incident case of disease • Case verification categories: • Laboratory confirmed cases • Positive culture or nucleic acid amplification test • Positive AFB smear when culture not attainable • Clinical case definition • Positive tuberculin skin test or positive interferon gamma release assay • Signs and symptoms of TB disease • Current treatment for TB disease • Completed diagnostic evaluation • Provider diagnosis • Diagnosed by health care provider • Does not fulfill all criteria necessary to meet laboratory or clinical case definitions

  4. TB Cases, All Ages, by Age Group, 1993–2012 TB Cases Year

  5. TB Case Rates, All Ages, by Age Group,1993–2012 TB Case Rate per 100,000 Year Note: Rates presented on a logarithmic scale

  6. Percent of Pediatric TB Cases by Age Group,1993–2012 N=19,840

  7. Pediatric TB Cases by Age Group, 1993–2012N=19,840 TB Cases Year

  8. Pediatric TB Case Rates by Age Groups, 1993–2012N=19,840 TB Case Rate per 100,000 Year Note: Rates presented on a logarithmic scale

  9. Pediatric TB Cases by Race/Ethnicity, 1993–2012N=19,840 Year Note: Unknown, multiple race/ethnicity, and Native Hawaiian and Other Pacific Islander not shown

  10. Pediatric TB Case Rates by Race/Ethnicity, 1993–2012N=19,840 TB Case Rate per 100,000 Note: Rates presented on a logarithmic scale. American Indian/Alaska Native and Native Hawaiian and Other Pacific Islander rate not shown because of small denominators

  11. Pediatric TB Case Rates by Age GroupsU.S.-born, 1994–2012N=14,780 TB Case Rate per 100,000 Year Note: Rates presented on a logarithmic scale. Data not available before 1994.

  12. Pediatric TB Case Rates by Age GroupsForeign-born, 1994–2012N=4,986 TB Case Rate per 100,000 Year Note: Rates presented on a logarithmic scale. Data not available before 1994.

  13. Number and Percent of Pediatric TB Cases by U.S. and Foreign Birth, 1993–2012 (%) Number of Pediatric TB Cases

  14. Number of Pediatric TB Cases with Foreign Birth by Birth Country*, by 6-Year Intervals, 1995–2012N=4,187 * Ranked by counts

  15. States with the Greatest Percent of the U.S. Total Pediatric TB Cases, 1993–2012N=19,840

  16. States with Greatest Numbers of Pediatric TB Cases, 1993–2012 *Average percent of total state cases that are pediatric, for all years **Time-averaged annual rate per 100,000

  17. States with Greatest Percent of Pediatric TB Cases, 1993–2012 *Average percent of total state cases that are pediatric, for all years **Time-averaged rate per 100,000

  18. States with Greatest Rate of Pediatric TB Cases, 1993–2012 *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

  19. Pediatric TB Cases by Case Verification Criterion*, 1993–2012N=19,840 ProviderDiagnosis 23% Laboratory Confirmed 26% Clinical Case 51% *Based on the public health surveillance definition for TB [MMWR 1997:46(No. RR-10):40-41]

  20. Pediatric TB Cases by Case Verification Criterion by Age Group, 1993–2012 N=19,840 Laboratory Confirmed Clinical Case Provider Diagnosis

  21. Pediatric TB Cases by Site of Disease, 1993–2012 *Any extrapulmonaryinvolvement 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.

  22. Pediatric TB Cases by Site of Disease by Age Group, 1993–2012N=19,840 Pulmonary Both Extrapulmonary

  23. Pediatric TB Cases with Any Extrapulmonary Involvement* by Age Group and Selected Sites of Disease, 1993–2012N=19,840 * “Any extrapulmonary involvement” includes: 1.) extrapulmonary only, and 2.) both extrapulmonary and pulmonary. Note: Combine the total extrapulmonary percent shown with the pulmonary percent in slide #21 to obtain 100% for each age group.

  24. Percent of TB Cases in Children Age < 1 Year With Any ExtrapulmonaryInvolvement*, 1993–2012N=1,992 • * “Any extrapulmonary involvement” includes: 1.) extrapulmonary only, and 2.) both extrapulmonary and pulmonary.

  25. Percent of TB Cases in Children Age 1–4 Years With Any ExtrapulmonaryInvolvement*, 1993–2012N=9,692 • * “Any extrapulmonary involvement” includes: 1.) extrapulmonary only, and 2.) both extrapulmonary and pulmonary.

  26. Percent of TB Cases in Children Age 5–9 Years With Any Extrapulmonary Involvement*, 1993–2012N=4,474 • * “Any extrapulmonary involvement” includes: 1.) extrapulmonary only, and 2.) both extrapulmonary and pulmonary.

  27. Percent of TB Cases in Children Age 10–14 Years With Any Extrapulmonary Involvement*, 1993–2012N=3,682 • * “Any extrapulmonary involvement” includes: 1.) extrapulmonary only, and 2.) both extrapulmonary and pulmonary.

  28. Pediatric TB Cases by HIV Status, 1993–2011*N=19,354 Information on HIV results are not available for the majority of pediatric TB cases (75.9%) *California HIV data missing from 2005 - 2010; Vermont HIV data through 2006 only. **Pediatric TB cases with positive HIV test results divided by all pediatric TB cases. Note: Through 2004, California only reported positive HIV test results based on TB and AIDS registry matching; all other California TB cases were classified as “Unknown.”

  29. Number and Percent of Culture-Confirmed Pediatric TB Cases with Drug Resistance, 1993–2011 First line drugs are isoniazid, rifampin, pyrazinamideand ethambutol MDR TB = resistance to at least isoniazidand rifampin

  30. Pediatric TB Cases by Use of Directly Observed Therapy (DOT), 1993–2010N=18,719* Percentage Year *Pediatric TB cases with patient alive at diagnosis and started on treatment

  31. Pediatric TB Cases by Treatment Outcome 1993–2010N=18,719* Note: Cause of death not recorded in TB case reports until 2009; “Moved” no longer a valid response *Pediatric TB cases with patient alive at diagnosis and started on treatment **Other includes refused, other, unknown, and missing

  32. Deaths Occurring Among Pediatric TB Cases, by Age Group, 1993–2010N=18,777 Note: Cause of death not recorded in TB case reports *Death includes died during therapy or dead at TB diagnosis

More Related