Definition

Rate of newly reported cases of tuberculosis per 100,000 population.

Numerator

Number of tuberculosis cases by count date.

Denominator

Number of persons in the population.

Why Is This Important?

Tuberculosis (TB) is caused by a type of bacteria called ''Mycobacterium tuberculosis''. TB is typically spread through the air when a person with TB disease of the lungs or throat expels tiny airborne particles (droplet nuclei). People nearby may breathe in these particles and become infected. People who have latent TB infection do not feel sick, do not have symptoms, and cannot spread TB. But, they may develop active TB disease at some time in the future. The bacteria usually attack the lungs but may attack any part of the body. The United States experienced a resurgence of TB disease between 1985 and 1992 when the number of TB cases increased by 20%. Early detection and treatment of TB are essential to control the spread of the disease and prevent outbreaks.

Other Objectives

'''HP2030 Objective IID-17:''' Reduce the tuberculosis (TB) case rate for persons living in the United States [[br]] '''U.S. Target:''' 1.4 cases per 100,000 population

How Are We Doing?

In 2023, 34 cases of TB were reported in Utah. For the five-year period from 2019 to 2023, Utah had an average of 28.0 cases of TB reported per year. In 2023 the TB case rate in Utah remained consistent at 1.0 per 100,000 compared to 2022.

How Do We Compare With the U.S.?

From 2018 to 2022, the case rate of TB in Utah was 0.76 per 100,000 people compared to the national case rate 2.5 per 100,000 people.

What Is Being Done?

The TB Control Program at the Utah Department of Health and Human Services is charged with reducing the incidence of TB disease through timely reporting and treatment. The Program also provides screening and preventive therapy for those with TB infection. There are 13 local health departments throughout Utah that are the front line of TB case management for the state. Their responsibilities include: * diagnosis of TB infection and active TB disease * treatment of TB infection and active TB disease * ensuring patient adherence to treatment * screening of high-risk populations * coordination/referral * providing culturally appropriate client education.

Available Services

Contact information for Utah Local Health Departments is given below: Bear River Health Department[[br]] 655 East 1300 North[[br]] Logan, Utah 84341[[br]] Phone: (435) 792-6500 Central Utah Public Health Department[[br]] 70 Westview Drive[[br]] Richfield, Utah 84701[[br]] Phone: (435) 896-5451 Davis County Health Department[[br]] 22 S State St[[br]] Clearfield, Utah 84015[[br]] Phone: (801) 525-5000 Salt Lake County Health Department[[br]] 610 South 200 East [[br]] Salt Lake City, Utah 84111[[br]] Phone: (385) 468-4222 San Juan Public Health[[br]] 735 S 200 West #2[[br]] Blanding, UT 84511[[br]] Phone: (435) 587-3838 Southeast Utah Health Department[[br]] 28 South 100 East[[br]] Price, Utah 84501[[br]] Phone: (435) 637-3671 Southwest Utah Public Health Department[[br]] 620 S 400 East, Ste 400[[br]] St George, Utah 84770[[br]] Phone: (435) 673-3528 Summit County Public Health Department[[br]] 650 Round Valley Drive[[br]] (at Quinns Junction)[[br]] Park City, Utah 84060[[br]] Phone: (435) 333-1500 Tooele County Health Department[[br]] 151 N Main Street[[br]] Tooele, Utah 84074[[br]] Phone: (435) 277-2300 TriCounty Health Department[[br]] 133 South 500 East[[br]] Vernal, Utah 84078[[br]] Phone: (435) 247-1177 Utah County Health Department[[br]] 151 S University Ave[[br]] Provo, Utah 84601[[br]] Phone: (801) 851-3000 Wasatch County Health Department[[br]] 55 South 500 East[[br]] Heber City, Utah 84032[[br]] Phone: (435) 657-3307 Weber-Morgan Health Department[[br]] 477 23rd St[[br]] Ogden, Utah 84401[[br]] Phone: (801) 399-7100

Relevant Population Characteristics

The racial/ethnic distribution of tuberculosis (TB) in Utah for the five-year period of 2019-2023 was as follows: 40.0% occurred in persons of Hispanic ethnicity, 27.9% in Asians, 12.9% in Whites, 7.1% in Blacks/African Americans, 10.0% in Native Hawaiians/Other Pacific Islanders, and 2.1% in American Indian/Alaskan Natives. Over the past five years in Utah, more than 96% of Black/African American and Asian persons with TB were non-US-born. The racial/ethnic distribution of TB morbidity for the United States in 2022 was as follows: 34.3% occurred in Asians; 33.9% in persons of Hispanic ethnicity; 15.8% in Blacks/African Americans; 10.2% in Whites; 1.2% in those with multiple races; 1.3% in American Indians/Alaskan Natives; and 1.9% in Native Hawaiians/Other Pacific Islanders. (CDC. ''Tuberculosis - United States, 2022'', 2023). In 2023, 87.9% of the persons diagnosed with TB in Utah were non-US-born. In 2022, 72.4% of the national case total of persons diagnosed with TB were non-US-born. (CDC. ''Tuberculosis - United States, 2022'', 2023). These numbers show the importance of effectively screening and treating individuals from high TB prevalence areas.

Health Care System Factors

It is very important that patients with active tuberculosis (TB) disease adhere to their treatment regimen. Treatment adherence is not only important for effective therapy in patients, but also to prevent an increase in cases of drug-resistant ''Mycobacterium tuberculosis''. From 2019 to 2023, drug susceptibility testing was completed on 100% (97 of 97) of the TB cases confirmed by laboratory culture. During this period, 8% of culture isolates had resistance to one or more anti-TB medications relative to the total number of laboratory culture confirmed TB cases. These statistics highlight the need for continued drug sensitivity testing for all TB culture isolates, and the need for directly observed therapy (DOT) for all TB patients to ensure that they take all their medications.

Risk Factors

About 10% of persons with tuberculosis (TB) infection who have normal immune systems will develop TB disease at some point in life. Certain conditions increase the odds that infection will progress to active disease, including: *HIV infection *recent exposure (within the past two years), particularly children <5 years of age *certain medical conditions: silicosis, gastrectomy, low body weight (>=10% below ideal), chronic renal failure/dialysis, diabetes mellitus, organ transplant, carcinoma of head or neck, or high-dose corticosteroid therapy *illicit injection drug use or other high-risk substance abuse (e.g., crack cocaine) *a history of inadequately treated TB. [[br]] [[br]] HIV infection is the strongest risk factor for progression of TB infection to TB disease. For people infected with TB and HIV, the risk of developing TB disease is about 7% to 10% per year. During the years 2019-2023, about 2.2% of persons with TB in Utah were co-infected with HIV. This is lower than the 4.7% of persons with TB in the United States in 2022 for whom test results were available who were co-infected with HIV (CDC. ''Tuberculosis - United States, 2022'', 2023).

Health Status Outcomes

Although Utah is a low-incidence tuberculosis (TB) state, the state has faced the challenge of managing cases of multidrug-resistant tuberculosis (MDR TB) in the past several years. MDR TB is defined as cases of TB disease in persons whose ''Mycobacterium tuberculosis'' isolates are resistant to at least isoniazid and rifampin, the two most effective TB medications. This makes treatment of MDR TB more difficult, prolonged, and costly. Treatment of MDR TB can last 18-24 months or more. However, rates of MDR TB are decreasing and Utah only had one case of MDR TB reported from 2018 to 2023.

Data Notes

The 2023 rates were calculated using population numbers provided by the Kem. C. Gardner Policy Institute Population Estimates

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

Age at report.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

Race/ethnicity categories are mutually exclusive and cases may not be in more than one category.

Data Notes

Race/ethnicity categories are mutually exclusive and cases may not be in more than one category.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

Non-US-born persons were born outside the 50 states or the District of Columbia and who did not have at least one parent who was a US citizen.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

A given case may have no risk factors or may have multiple risk factors. Substance abuse is in the 12 months prior to TB diagnosis.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

A given case may have no risk factors or may have multiple risk factors. Homeless cases are those who experienced homelessness in the 12 months prior to TB diagnosis.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

Prior to 1999, persons with TB were classified as having either pulmonary or extrapulmonary disease; there was no third category for persons having both types of disease. Pulmonary - TB in the lung; Extra-pulmonary - TB in other body part.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

"1-Plus" = Resistant to at least one drug [[br]] "INH" = Resistant to at least Isoniazid (INH) [[br]] "MDR TB" = Multidrug Resistant TB, which is defined as ''M. tuberculosis'' that is resistant to at least INH and Rifampin (RIF). [[br]] [[br]] A TB case can be resistant to more than one drug.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Notes

For TB patients for whom indicated length of therapy was 12 months or less and who started treatment. Excludes patients who died within 366 days of initiating treatment. From 2009, patients who moved out of the United States within 366 days of initiating treatment are also excluded if treatment was not completed.

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

Data Source

Utah Department of Health and Human Services Office of Communicable Diseases

References and Community Resources

INTERNET RESOURCES FOR TUBERCULOSIS: American Thoracic Society[[br]] [https://www.thoracic.org] Centers for Disease Control and Prevention, Division of Tuberculosis Elimination[[br]] [https://www.cdc.gov/tb] EthnoMed[[br]] [http://www.ethnomed.org] Francis J. Curry National Tuberculosis Center[[br]] [https://www.currytbcenter.ucsf.edu] Heartland National Tuberculosis Center[[br]] [https://www.heartlandntbc.org] International Union Against Tuberculosis and Lung Disease[[br]] [https://www.theunion.org] National Institute for Occupational Safety and Health[[br]] [https://www.cdc.gov/niosh/topics/tb/] National Jewish Medical and Research Center[[br]] [https://www.nationaljewish.org/conditions/tuberculosis-tb] National Library of Medicine[[br]] [https://www.ncbi.nlm.nih.gov/PubMed/] Occupational Safety and Health Administration[[br]] [https://www.osha.gov/SLTC/tuberculosis/index.html] Southeastern National Tuberculosis Center[[br]] [https://sntc.medicine.ufl.edu] Utah Department of Health and Human Services[[br]] [https://epi.utah.gov/tuberculosis-tb/] WHO Global TB Programme[[br]] [https://www.who.int/health-topics/tuberculosis#tab=tab_1]