OCR Text |
Show Tuberculosis (Cases in 1996 in Utah = 58) Tuberculosis (TB) continues to be a major public health problem, both nationally and internationally. Each year there are an estimated 8 to 10 million new cases, with in 3 million deaths reported world wide. In Utah, the Utah Department of Health Bureau of Epidemiology reports that TB has re-emerged as a public health problem in Utah after a 30 year period of decline. Utah's incidence rate for tuberculoses has consistently been lower than the national rate. The Utah:U.S. ratio shows Utah rates to be approximately 30% of the national rate. Through 1985, tuberculosis rates in Utah and the United States were declining. However, since that time, TB incidence has been generally increasing. Tuberculosis is an infectious disease, but it has many social aspects as well. Poverty, overcrowding, and malnutrition may all contribute to contracting this disease. The homeless population is therefore at a higher risk for TB. In Utah from 1991 to 1993, the homeless population comprised 25% of reported cases. This is alarming for many reasons. First, the homeless population represents only 1% of the state's total population but 25% of the reported cases. Second, there may be a much higher incidence due to the under-reporting of disease in the homeless. Furthermore, it is particularly difficult to track and treat TB in the homeless population because many do not have regular contact with a health care delivery system. Currently, efforts are being made by the staff of the community homeless shelters to screen the residents for TB. As screening increases, an even higher incidence of TB would be expected. Other populations may be at a greater risk for TB as well. These include low-income groups, residents of long-term care facilities, the elderly, and AIDS patients. Active TB is more likely with a compromised immune system, making people with AIDS more vulnerable to disease. The data below are based on reported cases. This may not represent total incidence in the community. Better ways of assessing at risk populations are needed. Table 59. Tuberculosis* Utah:U.S. Year Utah U.S. (Ratio) 1970 1.2 18.2 0.07:1 1981 4.2 11.9 0.35:1 1982 3.3 11.0 0.30:1 1983 2.9 10.2 0.28:1 1984 2.5 9.4 0.27:1 1985 1.9 9.3 0.20:1 1986 2.6 9.4 0.28:1 1987 1.7 9.3 0.18:1 1988 2.1 9.1 0.23:1 1989 3.3 9.5 0.35:1 1990 3.0 10.3 0.29:1 1991 2.6 10.4 0.25:1 1992 4.3 10.5 0.41:1 1993 2.5 9.8 0.26:1 1994 2.9 9.4 0.31:1 1995 2.5 7.6 0.32:1 1996 2.9 8.0 0.36:1 "Incidence rate per 100,000 population. Table 59. Sources: Kent, J.T. 1993 Medical Clinics of North America Epidemiology of Multidrug-resistant Tuberculosis in the U.S. vol. 77 No. 6, November 1993. Utah Department of Health, Bureau of Epidemiology. Unpublished Report.Utah 1996: Utah Dept of Health, Bureau of Epidemiology. Annual Communicable Disease Reports. Unpublished ReportUS 1996: Center for Disease Control (1997). Summary of Notifiable Diseases. United States 1996 Morbidity and Mortality Weekly Report. 45(53). Atlanta, GA: Government Printing Office, p 73. Figure 33 20 -T- Incidence Rates per 100,000 10 --Population ^ 0 Tuberculosis Utah U.S. 1970 1982 1984 1986 1988 1990 1992 1994 1996 105 |