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Show Tuberculosis (Cases in 1998 in Utah = 52) Tuberculosis (TB) continues to be a major public health problem, both nationally and internationally. 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. Through 1985, tuberculosis rates in Utah and the United States were declining. However, since that time, TB incidence has been generally increasing. 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 a third of the national rate. 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 total reported cases. In Utah, 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. Wasatch Homeless Health Care provides screenings for all persons seeking shelter to Salt Lake County shelters. 100% of people entering shelters are screened except for winter overflow emergency shelter, which had about a 64% screening ratio in 1998. Other populations may be at a greater risk for TB as well. These include low-income groups, recent immigrants-including undocumented workers, Figure 27_________________________ 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 60. Tuberculosis* Utah:U.S. Year Utah U.S. (Ratio) 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 1997 1.8 6.7 0.27:1 1998 2.5 5.4 0.46:1 * Incidence rate per 100,000 population. Table 60 Sources: Utah 1981-1998: Utah Dept of Health, Bureau of Epidemiology. Annual Communicable Disease Reports. Unpublished Report. US 1981-1998: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention. Summary of Notifiable Diseases. United States, Morbidity and Mortality Weekly Report, (online) Available: www2.cdc.gov/mmwr/distrnds.html Tuberculosis 20 j Incidence Rates per 100,000 10 --Population c 0 ¦Utah U.S. 1970 1982 1984 1986 1988 1990 1992 1994 1996 1998 90 |