Epidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2011 Surveillance,...
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Transcript of Epidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2011 Surveillance,...
Epidemiology of Tuberculosis in Correctional Facilities, United States,
1993-2011
Surveillance, Epidemiology and Outbreak Investigations BranchDivision 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
The National Tuberculosis (TB) Surveillance System
Database of all confirmed cases of TB disease reported to CDC A confirmed case is one that is laboratory confirmed,
meets the clinical case definition, or is confirmed by the provider (in absence of adequate laboratory or clinical information)
Since 1993, CDC has collected demographic, risk factor, clinical, and laboratory information on TB cases residing in correctional facilities at the time of diagnosis
Surveillance Reporting forResidence of a Correctional Facility
Resident of correctional facility at the time of TB diagnosis (Yes, No, or Unknown)
Types of correctional facilities: Federal Prison State Prison Local Jail Juvenile Correctional Facility Other Correctional Facility Unknown
A separate question about “Immigration and Customs Enforcement” (ICE) custody was added in 2009 Persons in ICE custody can be housed in stand-alone ICE detention
centers or other correctional facilities. Questions pertaining to TB patients diagnosed in ICE facilities were
80% complete in 2009; 95% complete in 2011.
TB Cases in Correctional Facilities
In 2011, a total of 9,946 TB cases ≥ 15 years old were reported in the United States 9,884 of those (99.4%) had information on residence in
correctional facilities 424 (4.3%) cases were reported as residents of correctional
facilities at time of TB diagnosis
Between 1993 and 2011, 3.8% (n=11,721) of TB cases reported in the U.S. were residents of correctional facilities at the time of diagnosis.
* http://www.cdc.gov/tb/topic/populations/correctional/default.htm
Counts of TB Cases in Correctional Facilities Compared to All TB cases,
1993-2011
0
5,000
10,000
15,000
20,000
25,000
30,000
TB Cases in Correctional Facilities
Total TB Cases
Year of Report
TB
Cas
es (
Cou
nt)
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0
1
2
3
4
5
6
7
8
9
TB Cases in Correctional Facilities, Percentage of All Reported TB Cases, 1993-
2011
Year of Report
Per
cent
age
of a
ll T
B C
ases
Percent of TB Cases in Correctional Facilities by Type of Facility, 1993-2011
Juvenile Facility 1%
Federal Prison7%
Local Jail51%Other
10%
State Prison31%
Unknown0.4%
TB Cases in Correctional Facilities inU.S.-born and Foreign-born Persons, 1993-2011
30%
1%69
%
Foreign BornUnknown Origin of BirthU.S. Born
Year
Num
ber
of
TB
Case
sNumber of TB Cases in Correctional
Facilities inU.S.-born and Foreign-born Persons,
1993-2011
0
100
200
300
400
500
600
700
800
900
1000
U.S. BornForeign Born
TB Cases in Correctional Facilities by Race/Ethnicity and Percent of Foreign Born,
1993–2011
Race/Ethnicity
Num
ber
of
TB
Case
s
Black Hispanic White Asian Other*0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
U.S. BornForeign Born
4% 74% 4% 95% 12%
Note: Percentage indicates the proportion of foreign-born TB cases. Persons identified as white, black, Asian, or of other race are all non-Hispanic. Persons identified as Hispanic might be of any race.* Persons included in this category are American Indian/Alaska Native, Native Hawaiian or other Pacific Islander, multiple race, or unknown race and comprise <2% of all incarcerated TB cases.
Percent Foreign Born
Percent of TB Cases in Correctional Facilities
by Immigration and Customs Enforcement (ICE) Status, 2011
63%
37%
Not in ICE CustodyIn ICE Custody
TB Cases in Correctional Facilities by Type of Facility and Immigration and Customs
Enforcement (ICE) Status, 2011C
ount
of
Case
s b
y IC
E S
tatu
s
Type of Correctional Facility
Local Jail State Prison
Other Federal Prison
0
20
40
60
80
100
120
140
160
In ICE CustodyNot in ICE Custody
15-24 25-44 45-64 65+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
In ICE
Not in ICE
Age Group (years)
TB Cases in Correctional Facilities by Age Group and Percent in Immigration and Customs
Enforcement (ICE), 2011
ICE S
tatu
s
TB Cases in Correctional Facilities by Age Group, 1993-2011
0.1%12.5%
62.7%
23.2%
1.5%
Age 0-14
Age 15-24
Age 25-44
Age 45-64
Age 65+
Unknown
NOTE: Data for ages missing/unknown each accounted for <0.1% of outcomes.
TB Cases ≥ Age 15 in Correctional Facilities
by Age Group, 1993-2011
Num
ber
of
TB
Case
s
Year of Report
19931995
19971999
20012003
20052007
20092011
0
200
400
600
800
1,000
1,200
Age 65+
Age 45-64
Age 25-44
Age 15-24
NOTE: For any year depicted, missing/unknown data accounted for <0.1% of outcomes.
82%
9%
9%
Juvenile Correc-tion Facility
Local Jail
Unknown
TB Cases < Age 15 in Correctional Facilities by Correctional Facility Type,
1993-2011
Year of Report
Number of TB Cases in Correctional Facilities
by Sex, 1993-2011
Num
ber
of
TB
Case
s
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0
200
400
600
800
1,000
1,200
MaleFemale
TB Cases in Correction Facilities by Race/Ethnicity, 1993-2011
2.8%
42.2%
36.6%
16.8%
1.3% 0.3%
Asian
Black
Hispanic
White
Other
Unknown
*
* “Other” includes groups comprising <2% of total incarcerated TB cases (American Indian, Native Hawaiian/Pacific Islander, or Multiple Races)
TB Cases in Correctional Facilities by Race/Ethnicity, 1993-2011
Num
ber
of
TB
Case
s
Year of Report* “Other” includes groups comprising <2% of total incarcerated cases (American Indian, Native Hawaiian/Pacific Islander, or Multiple Races). Incarcerated TB cases of unknown race/ethnicity are 0.3% of total cases and are not shown.
19931995
19971999
20012003
20052007
20092011
0
200
400
600
800
1,000
1,200
AsianBlackHispanicWhiteOther *
65%
35%
HIV Status Known
HIV Status Unknown
Percent of TB Cases in Correctional Facilities by Whether HIV Test Results
Known*, 1993-2011
*
*Known HIV status includes positive, negative and indeterminate results.
Percent of TB Cases by HIV Status and Correctional Facility Status,
1993–2011
HIV Status
Perc
en
t
Positive Negative Indeterminate Refused Not offered Unknown0
5
10
15
20
25
30
35
40
45
50
TB Cases not in Correctional Facil-ities
TB Cases in Correctional Facilities
Treatment of TB Cases in Correctional Facilities by Use of
Directly Observed Therapy (DOT), 1993-200918%
71%
9%
2%
Both Directly Observed and Self Administered Totally Directly ObservedTotally Self AdministeredUnknown
Percent of TB Cases in Correctional Facilities at the Time of Diagnosis by Treatment
Completion, 1993-2009
73%
6%
11%
8%2% 1%
Completed Therapy
Died
Lost
Moved
Other
Refused
NOTE: Data for “Adverse Treatment Event” and “Unknown” each accounted for <0.1% of outcomes.
Percent of TB Cases by Treatment Completion Status and Correctional
Facility Status, 1993-2009
NOTE: Data for “Adverse Treatment Event” and “Unknown” each accounted for <0.1% of outcomes.
Treatment Status
Perc
en
t
Com-pleted
Therapy
Died Lost Moved Other Refused0
10
20
30
40
50
60
70
80
90
All TB CasesAll TB Cases in Correc-tional Facilities
Percent of TB Cases in Correctional Facilities by Reported History of Excess Alcohol Use Status,
1993-2011
57%28%
16%
No History of Excess Alcohol Use
History of Excess Alcohol Use
Percent of TB Cases in Correctional Facilities by Reported History of Injection Drug Use, 1993-
2011
73%
11%
16% No History of Injection Drug
Use
History of Injection Drug Use
Unknown History of Injection Drug Use
TB Cases in Correctional Facilities by ReportedHistory of Non-Injection Drug Use Status, 1993-
2011
57%
26%
17%
No History of Non-Injection Drug UseHistory of Non-Injection Drug UseUnknown History of Non-In-jection Drug Use
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: http://www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
National Center for HIV/AIDS, Viral Hepatitis, STD , and TB Prevention
Division of Tuberculosis Elimination