Tuberculosis — United States, 2018

Abstract

sex, self-reported race/ethnicity, and country of birth), clinical information (e.g., reason for TB evaluation, anatomic site of disease, test results, and therapy administered), and information on TB risk factors (e.g., human immunodeficiency virus [HIV] infection status, history of homelessness, and residence in a congregate setting). According to U.S. Census Bureau definitions, a "U.S.-born" person is classified as one born in the United States or a U.S. territory or born abroad to a U.S. citizen parent. Race/ethnicity data are collected and reported using federal classification standards; Hispanics/Latinos can be of any race, and all other reported race categories are non-Hispanic/Latino. CDC derived the denominators used to calculate national and state TB incidence from July 2018 U.S. Census Bureau population estimates (2) and the denominators used to calculate TB incidence by national origin and race/ ethnicity from July 2018 Current Population Survey data (3). The number of reported TB cases and TB incidence (cases per 100,000 persons) for 2017 and 2018, as well as the percent changes from 2017 to 2018, were calculated for the 50 states and DC and for each U.S. Census Bureau division. The numbers of TB cases and TB incidence per 100,000 persons were calculated by national origin and race/ethnicity for 2015-2018. TB incidence declined 1.3% from 2017 to 2018 and an average of 1.6% per year during the last 4 years (2014-2018), a slower pace of decline than the 4.7% annual decline during 2010-2014. § State-specific TB incidence for 2018 ranged § These calculations are based on unrounded annual TB incidence rates. from 0.2 per 100,000 in Wyoming to 8.5 in Alaska, with a median rate of 1.9 (Table 1). Ten states (Alaska, California, Florida, Hawaii, Maryland, Massachusetts, Minnesota, New Jersey, New York, and Texas) and DC reported TB incidence above the national rate. As has been the case for over 2 decades, four states (California, Florida, New York, and Texas) accounted for approximately half of the reported cases of TB in the United States. Among the 9,029 TB cases reported in the United States in 2018, approximately two thirds (6,276 [69.5%]) occurred in non-U.S.-born persons, whereas 2,662 (29.5%) occurred in U.S.-born persons; 91 (1.0%) cases occurred in persons for whom no national origin was documented (Table 2). This distribution is similar to that in 2017, when 6,392 (70.3%) cases occurred in non-U.S.-born persons, 2,693 (29.6%) occurred in U.S.-born persons, and 9 (0.1%) occurred in persons for whom no national origin was documented. TB incidence among non-U.S.-born persons (14.2 cases per 100,000) decreased by 3.8% from 2017 to 2018, and the incidence among U.S.-born persons (1.0 cases per 100,000) decreased by 1.8% (Figure). ¶ ¶ The decrease in overall incidence does not fall within the range of decreases by national origin because, although the denominators used to calculate both rates increased from 2017 to 2018, the denominator used for rates by national origin (according to Current Population Survey data) increased by an additional 705,000 persons, compared with the denominator used to calculate the overall rate (according to U.S. Census Bureau data). This resulted in a larger calculated decrease in rate by national origin, compared with the overall rate.