Washington State Department of Health April 14, 2010 Washington State Cohort Review 2009 trends & 1...
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Transcript of Washington State Department of Health April 14, 2010 Washington State Cohort Review 2009 trends & 1...
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Washington State Department of HealthWashington State Department of HealthApril 14, 2010April 14, 2010
Washington State Cohort ReviewWashington State Cohort Review 2009 trends & 12009 trends & 1stst quarter quarter
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Annual TB Case RatesAnnual TB Case Rates
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Highlights of 2009 trendsHighlights of 2009 trends
•12.3% increase in number of TB cases in 12.3% increase in number of TB cases in 2009: 228 to 2562009: 228 to 256
•TB case rate: increased from 3.5 in 2008 to TB case rate: increased from 3.5 in 2008 to 3.8 in 2009(per 100,000 individuals)3.8 in 2009(per 100,000 individuals)
•Also in 2009: Also in 2009: – Started data management in PHIMSStarted data management in PHIMS– All time low TB case rate reported in WA All time low TB case rate reported in WA
in 2008in 2008
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2009 TB Case Rates by 2009 TB Case Rates by CountyCounty•Largest increase: Clark Co. (1.7 to 3.7)Largest increase: Clark Co. (1.7 to 3.7)
•Largest decrease: Yakima Co. (4.7 to Largest decrease: Yakima Co. (4.7 to 2.1)2.1)
•Top 5 case rates:Top 5 case rates:
1.1. King: 6.8King: 6.8
2.2. Pierce: 4.2Pierce: 4.2
3.3. Snohomish: 4.0Snohomish: 4.0
4.4. Clark: 3.7Clark: 3.7
5.5. Thurston 3.2Thurston 3.2
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2009 TB Cases by 2009 TB Cases by demographicsdemographics
•By race/ethnicity:By race/ethnicity:– Largest increase in Asians (18.6 to 24.7)Largest increase in Asians (18.6 to 24.7)– Largest decrease in AI/AN (6.3 to 4.2)Largest decrease in AI/AN (6.3 to 4.2)
•78% foreign born (continued trend in 78% foreign born (continued trend in increase)increase)
•Decrease in proportion of pediatric casesDecrease in proportion of pediatric cases
•Increase in proportion of 45+ y.o. casesIncrease in proportion of 45+ y.o. cases
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Trend in Age (2004 -2009)Trend in Age (2004 -2009)
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Trend in Age in Foreign-born Trend in Age in Foreign-born cases (2004 – 2009)cases (2004 – 2009)
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Trend in Age in US born Trend in Age in US born cases (2004 – 2009)cases (2004 – 2009)
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In progress…In progress…
•Further analysis on timeliness!Further analysis on timeliness!
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Distribution of 2009 cases Distribution of 2009 cases by Quarter and Countyby Quarter and County
QUARTERQUARTERSS
LocationLocation
King Co.King Co. Outside King Outside King Co.Co.
11st st (n=29)(n=29) 1111 18 (62%)18 (62%)
22nd nd (n=60)(n=60) 3737 23 (38%)23 (38%)
33rd rd (n=82)(n=82) 3131 51 (62%)51 (62%)
44th th (n=85)(n=85) 5151 34 (40%)34 (40%)
TOTAL TOTAL (n=256)(n=256)
130130 126 (49%)126 (49%)
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Quarter 1 (Jan – Mar) of 2009 Quarter 1 (Jan – Mar) of 2009 Highlights for Outside King co.Highlights for Outside King co.
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CASES: Treatment HxCASES: Treatment Hx•TOTAL: 18 casesTOTAL: 18 cases
•No pediatric casesNo pediatric cases
•100% initiation on tx100% initiation on tx
•DOT 83% of all (100% of Sm+ case)DOT 83% of all (100% of Sm+ case)– 67% total DOT67% total DOT– 17% DOT in combination with self-admn17% DOT in combination with self-admn
•6% HIV testing not offered:6% HIV testing not offered:– 1 Sm-Cul+ case1 Sm-Cul+ case
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CASES: Tx completionCASES: Tx completion
•83% likely to complete83% likely to complete– 78% completed78% completed– 6% currently on6% currently on
•17% moved:17% moved:– 1 Sm-Cul+ case1 Sm-Cul+ case– 2 ‘other’ cases2 ‘other’ cases
•0% lost0% lost
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Timeliness Timeliness (Median number of days)(Median number of days)
•Start of Meds: Start of Meds: 1 day1 day
•Lab sputum collection: Lab sputum collection: 0 (same day)0 (same day)
•Culture testing: Culture testing: 20.5 days20.5 days
•HCP to LHJ: HCP to LHJ: same daysame day
•Lab to LHJ: Lab to LHJ: same daysame day
•LHJ to DOH: LHJ to DOH: 1 day1 day
•Susceptibility: Susceptibility: 20.5 days20.5 days
•Sm+ date to contact identification: -2.5Sm+ date to contact identification: -2.5
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Contacts: Jan – Mar 2009Contacts: Jan – Mar 2009
•86 contacts identified for 18 cases86 contacts identified for 18 cases
•87% tested87% tested
•64% evaluated64% evaluated
•17% infected17% infected
•0% diseased0% diseased
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Contacts: Tx historyContacts: Tx history
•8% (1 of 13) of infected didn’t start tx8% (1 of 13) of infected didn’t start tx
•20 contacts started treatment:20 contacts started treatment:– 60% infected60% infected– 40% not infected40% not infected– 55% completed tx55% completed tx– 5% refused tx5% refused tx– 0% lost, died, moved, provider disc.0% lost, died, moved, provider disc.
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Thank you!Thank you!