The Epidemiology of Tuberculosis in the U.S. Essay

Introduction

Epidemiology is the study of diseases and other health problems among groups of people (CDC, 2016). Descriptive epidemiologists determine the frequency and patterns of diseases in specific communities. Descriptive epidemiology, therefore, investigates who has a given health issue, how regularly the issue happens, and where it occurs. The information on who suffers from a specific disease, when, and where this happens helps explain why the health arises. On the other hand, health workers and policymakers use the information to design and implement intervention strategies.

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Tuberculosis (TB) is one of the most infectious diseases in the world. About 2 billion people in the world have TB (CDC, 2016). Further, the CDC estimates that 9 million people contract TB annually and that 1.5 million of them die (CDC, 2016). Thus, TB is one of the deadliest infectious diseases worldwide. As a result, the study of the frequency and patterns of TB in the U.S. is vital. Having credible information on who, where, and when TB incidences are common in the U.S. helps in the implementation of health policies including the allocation of resources necessary to prevent, cure, and control TB. The following is a summary of the epidemiology of TB in the United States.

Case Rate

A case rate is the number of TB cases at a given place and time divided by the size of the population during that period (CDC, 2016). The common representation of considering the number of cases per 100,000 people (CDC, 2016). For instance, "there were 9,582 new TB cases in a population of approximately 316,128,839...," therefore, the case rate was 3.0TB cases per 100,000 Americans in 2013 (CDC, 2016, p. 8).

The Distribution of TB Cases in the US per State

In 2016, there were 9,287 new cases of TB in the U.S. This number represents a 3.0% decrease of the 2015 9,546 cases (Deresinski, 2017). California, Texas, New York, and Florida led in the number of TB cases with 50.9% of all cases reported there (Kanabus, 2017). On the other hand, Wyoming reported the least number of TB cases. It had a 0.2 case rate, while Hawaii had the biggest case rate of 0.8 (Kanabus, 2017). This data presents a common pattern. The four states leading in the number of TB cases have the largest population sizes in the U.S. Conversely, Wyoming is the least populated. The figure below graphically represents the incidence of TB in different states in the U.S. in 2015.

TB Prevalence and People

Most newly reported TB cases are among those people that are born outside the US. The case rate among people born outside the U.S. was 14.6TB cases compared to only 1.0TB cases for persons born in the U.S. in 2016 (Deresinski, 2017). Individuals born outside the U.S., therefore, contributed 66.2% of all TB cases compared to 31.6% of those born in the U.S. (Kanabus, 2017). TB was prevalent among people originating from Mexico, India, Vietnam, China, and the Philippines who accounted for 54.6% of cases among those people born in foreign lands (Kanabus, 2017).

The incidence of TB also varies depending or race and ethnicity. For instance, in 2013, 28% of TB cases were among Hispanics, 22% blacks or African American, and 31% in Asians. Respectively, these groups make up 17%, 12%, and 5% of the American population (CDC, 2016) Whites who make 63% of the population accounted for 15% of TB cases only (CDC, 2016). The case rate of Tb is, therefore, among Asian at 18.7 and the least case rate was in the Whites group at 1.0 in 2013.

The CDC list HIV-infected, children below the age of 5, cigarette smokers and drug abusers, and low-weight persons to be more susceptible to contracting TB (CDC, 2016, p. 11). Similarly, individuals who have cases of untreated or inadequately treated TB, and those who receive immunosuppressive therapy, have "silicosis, diabetes mellitus, chronic renal failure, leukemia, or cancer of the head, neck, or lung," or have had "gastrectomy or jejunoileal bypass, those who receive inadequate medical care, and low-income earners are at more risk to contract TB (CDC, 2016, p. 11). The risk of exposure is high to people who come from foreign regions such as Asia, Africa, Russia, Eastern Europe, or Latin America, those who come to contact with TB patients, health workers, and infants, children, and teenagers (CDC, 2016).

TB Prevalence and Time

Data indicate that TB case rates have reduced significantly since 1953. For instance, TB cases decreased by 6% from 1953 to 1984. However, there was a resurgent in the number of cases between 1986-1993 due to increase in immigration, development of multidrug-resistant (MDR TB), the HIV pandemic breakout, and inadequate funding to programs fighting the disease (CDC, 2016). Recent data shows the continual decline in TB case rate.

Conclusion

The epidemiology of TB illustrates the pattern of TB based on who, where, and when the disease infects. Understanding this gives medical practitioners and policymakers the information necessary to implement preventive and controlling measures to combat TB. In the U.S., most cases of TB are reported among people who are foreign-born. In addition, states that have large population sizes account for most of those cases. The susceptibility to TB infection also varies from one ethnic group to another. TB is also prevalent among HIV-infected persons, drug abusers, cigarette smokers, and children among others.

References

The Center for Disease Control and Prevention (CDC). (2016). Module 2: Epidemiology of tuberculosis. Atlanta, GA: CDC.

Deresinski, S. (2017, May 1). TB in the United States: Better, but still a long way to go. Retrieved from https://www.reliasmedia.com/articles/140610-tb-in-the-united-states-better-but-still-a-long-way-to-go

Kanabus, A. (2017). Information about tuberculosis. Retrieved from https://www.tbfacts.org/tb-statistics-united-states/