Tuberculosis Impact in Boston Residents: 2012 · BOSTON PUBLIC HEALTH COMMISSION COMMUNICABLE DISEASE CONTROL DIVISION Sputum Smear and Culture Results for Cases with Primary Pulmonary

Building a Healthy Boston

Tuberculosis Impact in Boston Residents: 2012

BOSTON PUBLIC HEALTH COMMISSIONInfectious Disease Bureau

Communicable Disease Control Division


BOSTON PUBLIC HEALTH COMMISSION ▪ COMMUNICABLE DISEASE CONTROL DIVISION

Number of TB Cases: Boston, 1995-2012

93 8779

8977 82 75

67 64 7057 61

4961 57 58

44 41

0

20

40

60

80

100

120

140

160

180

200

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Num

ber o

f cases



Incidence of TB: Boston, 2000-2012

13.912.7

11.4 10.911.9

9.7 10.48.3

10.4 9.7 9.8

7.1 6.6

02468101214161820

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Rate per 100

,000



Incidence of TB by Gender: Boston, 2010-2012

0

2

4

6

8

10

12

2010 2011 2012

Rate per 100

,000

Male Female



Percent of Reported TB Cases by Age Group: Boston, 2010-2012

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

< 25 years 25‐44 years 45‐64 years > 64 years

Percen

t

2010 2011 2012

Results may not equal 100% due to rounding



Incidence of TB by Age Group:Boston, 2010-2012

0

5

10

15

20

25

30

2010 2011 2012

Rate per 100

,000

< 20 years 20‐29 years 30‐39 years 40‐49 years 50‐59 years 60‐69 years >= 70 years



Percent of Reported Tuberculosis Cases by Race/Ethnicity: Boston, 2010-2012

0%

10%

20%

30%

40%

50%

60%

2010 2011 2012

Percen

t

White Black Hispanic Asian Other




Incidence of TB by Race/Ethnicity: Boston, 2010-2012

05101520253035404550

2010 2011 2012

Rate per 100

,000

White Black Hispanic Asian Other



Incidence of TB Among the Homeless:Boston, 2010-2012

0

10

20

30

40

50

60

70

80

90

100

2010 2011 2012

Rate per 100

,000



TB Cases by Birthplace: Boston, 2010-2012

0

20

40

60

80

100

2010 2011 2012

Percen

t

US Born Foreign Born




Length of US Residence for Foreign Born TB Cases Prior to TB Diagnosis: Boston, 2010-2012

0

20

40

60

80

100

2010 2011 2012

Percen

t

<1 year 1‐5 years 6‐10 years > 10 years




Region of Birth for TB Cases: Boston, 2012

0 5 10 15 20 25 30

Africa

Asia

Carribean

Central/South America

Europe

North America

Percent



Primary Site of TB Disease: Boston, 2012

64%

12%

7%17%

Pulmonary

Lymphatic

Pleural

Other



Sputum Smear and Culture Results for Cases with Primary Pulmonary TB: Boston, 2010-2012

0

5

10

15

20

2010* 2011** 2012***

Num

ber o

f cases

Smear+/Culture+ Smear+/Culture‐ Smear‐/Culture+ Smear‐/Culture‐

*Sputum samples unavailable for 2 cases**Sputum samples unavailable for 3 cases***Sputum samples unavailable for 1 case



Drug Resistance in TB Cases:Boston, 2012

Number

One Drug Streptomycin 1



Completeness of HIV Testing* of TB Cases: Boston, 2010-2012

0102030405060708090

100

2010 2011 2012

Percen

t

*Includes cases with negative, positive and indeterminate HIV test results



Percent TB Cases with HIV Infection:* Boston, 2010-2012

0

2

4

6

8

10

2010 2011 2012

Percen

t

*Of those tested



What health care sites are diagnosing and initiating TB treatment for Boston cases?

2011**N=42

2012*N=40

Diagnosing site Inpatient 29(66%) 31(77%)

Outpatient 15(34%) 9(22%)

Initial treatment site*

Inpatient 28(67%) 31(77%)

TB clinic 10(24%) 7(17%)

Hospital outpatient clinic

2(5%) 2(5%)

Other 2(5%) 0(0%)

*1 case died prior to identification of tuberculosis**2 case died prior to identification of tuberculosis Results may not equal 100% due to rounding



Who do Boston TB cases identify as their primary care site?

2011N=44

2012N=41

Hospital outpatient clinic 17 (39%) 17 (41%)

Community health center 13 (30%) 16 (39%)

Private practices 1 (2%) 1 (2%)

Other sites 6 (14%) 1 (2%)

None identified 7 (16%) 6 (15%)




Boston Residents with Latent TB Infection (N=1,446) Evaluated at the BPHC TB Clinic, Incidence by Gender: 2012

0 25 50 75 100 125 150 175 200 225 250 275

Male

Female

Rate per 100,000



Boston Residents with Latent TB Infection (N=1,446) Evaluated at the BPHC TB Clinic, Incidence by Age Group: 2012

0.0

50.0

100.0

150.0

200.0

250.0

300.0

350.0

400.0

Rate per 100

,000

<10 Years 10‐19 years 20‐29 years 30‐39 years

40‐49 years 50‐59 years 60‐69 years >= 70 years



Percent of Boston Residents with Latent TB Infection (N=1,446) Evaluated at the BPHC TB Clinic by Race/Ethnicity: 2012

26%

39%

19%

9%3% 4%

AsianBlackHispanicOtherUnknownWhite



Boston Residents with Latent TB Infection (N=1,446) Evaluated at the BPHC TB Clinic, Incidence by Neighborhood: 2012

0

100

200

300

400

500

600

Rate per 100,000



For More Information:

BOSTON PUBLIC HEALTH COMMISSIONCommunicable Disease Control Division

1010 Massachusetts AvenueBoston, MA 02118

Phone: 617‐534‐5611Fax: 617‐534‐5905

Website: www.bphc.org

Documents

Tuberculosis Impact in Boston Residents: 2012 · BOSTON PUBLIC HEALTH COMMISSION COMMUNICABLE DISEASE CONTROL DIVISION Sputum Smear and Culture Results for Cases with Primary Pulmonary