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Show TUBERCULOSIS (Cases in 1992 in Utah=78) Tuberculosis (TB) continues to be a major international public health problem, with an estimated 8 to 10 million new cases and 3 million deaths reported in the world each year.1 The Utah Department of Health, Bureau of Epidemiology reports that after a 30-year decline, TB has re-emerged as a serious public health problem even in Utah. Utah's incidence rate of tuberculosis (TB) has been consistently lower than the nation's (Table 58, Figure 35). The Utah:U.S. ratio shows Utah rates to be approximately one-third those of the nation through the 1980's. However, they increased from 0.41 to 1 in 1992. Tuberculosis incidence rates declined for both Utah and the nation through 1985. The Utah incidence rate slightly increased in 1986, 1989, and 1992, while it dropped again in 1993. The U.S. incidence rate remained at approximately 9 cases per 100,000 population from 1984 through 1989 and then increased to a rate of 10.5 in 1992. TB is considered a social disease as well as an infectious disease and is associated with poverty, overcrowding, and malnutrition. From 1991 to 1993, the homeless population in Utah composed 25% of reported cases.2 This is of particular concern when considering that the homeless represent less than one percent of Utah's total population. Also, this makes tracking tuberculosis particularly difficult because many people in low income groups do not have regular contact with the health care delivery system. Currently, efforts are being made by the staff of 1 Kent, J.T. 1993. Medical Clinics of North America. Epidemiology of Multidrug-resistant Tuberculosis in the U.S. Vol. 77. No. 6, November, 1993. 2 Utah Department of Health, Bureau of Epidemiology. Unpublished report. Figure 35 community shelters to screen people who reside there. As screening procedures improve and reach more of the population at risk, a higher incidence of TB will likely be reported. Other Utah populations at a greater risk for TB include low-income groups, residents of long-term care facilities, AIDS patients, and older populations. Certain disease conditions, such as TB, take advantage of a compromised immune system, making these people more vulnerable to increased infection. These data may only measure incidence among persons who seek medical treatment, while ignoring the total incidence of TB in the community. Better ways of assessing populations at increased risk are needed to ensure more accurate understanding. Table 58 Tuberculosis Incidence Rates per 100,000 Population Year Utah3 U.S.4 Utah:U.S. (Ratio) 1970 1.2 18.2 0.07:1 1981 4.2 11.9 0.35:1 1982 3.3 11 0.30:1 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 - - * Utah rates were computed using incidence reports from the Utah Department of Health and population estimates provided by the Utah Population Estimates Committee. ^ U.S. rates for 1970 through 1990 were computed using incidence reports and total population estimates as reported in Morbidity and Mortality Weekly Report. Tuberculosis Utah ........U.S. 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 Utah's Health: An Annual Review 1994 39 |