Tb messages may 4, 2005 volume 4, issue

May 4, 2005
Volume 4, Issue 1
limiting the local transmission of M. tuberculosis, such as case finding and treatment until cure, prompt Palm Beach County
contact investigations, identification and treatment of infected contacts, and the use of appropriate anti-tuberculosis treatment under Directly Observed Tuberculosis Annual
In 2004, several initiatives to improve management and services provided to TB patients were implemented countywide to ensure continuity of care and TB prevention. In 2005, new initiatives are being carried out to improve service delivery, partnership, and outreach to high-risk groups. Many people think that tuberculosis (TB) is a disease of the past-an illness that no longer threatens us Boubker Naouri, M.D., M.P.H.
today. However, with one third of the world's Tuberculosis Control Program Manager
population estimated to be infected with the bacteria Palm Beach County Health Department
that cause TB, this ancient disease is very much with us today. Among infectious diseases, TB remains the second leading killer in the world, with more than 2 In 2004, PBC reported 99 TB cases with a case rate of 7.9 per 100,000 (Figure I). This represents 9% of all TB This annual report describes the distribution of TB cases among the population of Palm Beach County (PBC). A total of 99 TB cases were reported during 2004 in PBC, an increase of 13% compared to 2003. Figure I. TB cases and rates, Palm Beach,
FL, 1993-2004
This increase is partially the result of two factors: Immigration from countries with high
prevalence
of
TB
In 2004, 64% of TB cases recorded in PBC were among foreign-born compared to 42% in 2003. HIV/AIDS epidemic
TB and HIV co-infection rate in PBC (27%) is 66% higher than the co-infection rate in the State of To meet these challenges, PBC Tuberculosis Control Program will keep focusing on control measures Palm Beach County Health Department, Broadway Health Center TB Control Program Phone: (561) 882-3110 Fax: (561) 845-4468 E-mail: [email protected] Figure IV. TB Foreign-born cases by country of origin, Palm
Eighty-one percent of 2004 TB cases were male. Beach, FL, 2004
Children ages 0 to 10 years accounted for 1% of cases (Figure II). The median age of TB cases was 44.5 years and ranged from 1 to 91 years of age. Persons Honduras
aged 41 to 50 made up the largest group of TB cases, Guatemala
Figure II. TB counted cases by age groups, Palm Beach,
Florida 2004
The proportion of the co-infection with HIV among TB cases recorded in 2004 was 27%, followed by excess of alcohol (22%) and non-injection drug use Figure V. TB cases by risk factors, Palm Beach,
Florida, 2004
The distribution of TB cases in PBC by race/ethnicity in 2004 was 32% Hispanic, 44% Black/Non-Hispanic, 21% White/Non-Hispanic, and 3% Asian/Pacific Figure III. TB counted cases by Race and Ethnicity, Palm
Beach, Florida, 2004
Risk factor
Birth in a geographic area where TB is endemic was Seventy-eight (78%) of the 2004 TB cases were again the most important risk factor for TB among 2004 pulmonary, six (6%) were both pulmonary and extra- cases, accounting for 67% of the cases. Most foreign- pulmonary and 15 (15%) were extra-pulmonary only born TB cases occurred among people born in Haiti (42.4%) followed by Guatemalan-born (18%) and Mexican-born (9%) (Figure IV). Thirty-nine percent of foreign-born cases occurred among those who had immigrated to the United States within the previous five years. Among those, 10 came during the previous year and 4 came during the same year they developed TB. Palm Beach County Health Department, Broadway Health Center TB Control Program Phone: (561) 882-3110 Fax: (561) 845-4468 E-mail: [email protected] Figure VI. TB cases by site of disease. Palm
Beach, Fl 2004
Ninety-one (92%) cases out of the 99 were managed by Palm Beach County Health Centers. The other 8 cases (8%) were managed by private physicians. Extra pulm .
Figure VIII presents the proportions of cases managed by each center. Forty-eight (48%) cases were managed by Broadway, 41(41%) by Delray and 10 (10%) by Belle Glade. Figure VIII. Management of TB active cases by Health
Center, Palm Beach, FL 2004
Sixty-five (65%) of the cases were culture positive, and of those 15 isolates presented a form of drug resistance (Figure VII). Four isolates were resistant to isoniazide (INH) alone, six to streptomycin (SM) alone. Three isolates was resistant to INH and Belle Glade
Broadway
ethambutol (EMB), one was resistant to INH, SM and EMB, one to INH/SM/EMB and ethionamide. Two isolates were multi-drug resistant (MDR-TB; resistant to at least INH and Rifampin). Seven (46.5%) of the Ninety-four (94%) of TB cases received Directly isolates that showed drug resistant were from foreign- Observed Therapy (DOT). All TB cases managed Figure VII. Tuberculosis drug resistance. Palm
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Beach, Florida, 2004
Do you have questions about TB?
• For more information about TB in English, Spanish or Creole, you can call the Florida TB Hotline: 1-800-4TB-INFO
• Case reporting: Phone: (561) 882-3271 / Fax: Palm Beach County Health Department, Broadway Health Center TB Control Program Phone: (561) 882-3110 Fax: (561) 845-4468 E-mail: [email protected]

Source: http://www.pbchd.com/pdfs/newsletters/tb/2005/TB_Messages_Vol-4_Iss_1-2004.pdf