2016 State and City TB Indicators Report

The National TB Indicators Report publishes key process and outcomes measures for TB control programs in the United States to evaluate progress towards TB elimination.  CDC selected the indicators used in the report, in cooperation with partners in state and local health departments. Indicators cover a wide range of important TB topics, including TB incidence, treatment completion for TB disease, known-HIV status, and treatment initiation and completion for contacts diagnosed with latent TB infection.

These data can help TB control programs:

• evaluate progress in TB prevention and control,
• monitor TB program performance,
• assess needs for education and technical assistance, and
• identify areas that need improvement

CDC provides funding for TB control activities in 50 U.S. states and 9 cities. Data for calculating these indicators come from the National TB Surveillance System and the Aggregate Reports for Program Evaluation.  For more information on the National TB Indicators Project, visit National TB Indicators Project Fact Sheet.

Highlights from the 2016 report are below.  For more details, view the full report [PDF].  If you need additional state-specific data not available in this report, contact your state TB control office.

TB Incidence

Measuring the number of new TB cases each year is the best overall indicator of progress towards TB elimination.  TB elimination is defined as less than 1 case per million persons per year.  In 2016, TB incidence in the United States was 2.9 overall TB cases per 100,000 persons (30 per million).

In 2016:

• 9 states and 9 cities reported incidences above the national average of 2.9 cases per 100,000.
• 41 states were at or below the national average.

The National TB Indicators Report contains additional details, including incidence rates for states and cities.

Completion of Therapy

Fully treating and preventing further spread of TB disease is key to TB control and elimination.  Although treatment for TB disease can be challenging to complete, there are several ways to increase treatment completion.  CDC has set a 2020 national target of 95.0% of TB cases completing a full treatment regimen for TB disease in 12 months or less.  The most recent national average, in 2014, for treatment completion for TB disease is 90.1%.

TB disease treatment is complex, and can take several months to complete.  It can take up to 2 years to have complete treatment information for TB patients.  Therefore, the most recent information available on completion of therapy is from 2014.

The National TB Indicators Report contains additional details, including treatment completion rates for states and cities.

HIV Status

Tuberculosis is a serious health threat for people living with HIV. People living with HIV are more likely to become sick with TB disease if they are exposed and become infected. Measuring the number of TB patients who are also tested for HIV and have a known HIV status is important to save lives and interrupt the spread of TB and HIV to others. CDC has set a 2020 national target of having HIV status known among at least 98.0% of TB cases. In 2016, the national average of TB cases having known HIV status was 89.9%.

The National TB Indicators Report contains additional details, including percentages of known HIV status for TB patients for states and cities.

Treatment for Latent TB Infection Among Contacts

TB programs work to identify people who may have been exposed to people with TB disease (often referred to as “contacts”), and offer testing and treatment for latent TB infection. People with latent TB infection can be treated to prevent the development of TB disease.  Identifying and treating people with latent TB infection is critical to achieving TB elimination.

Treatment Initiation Among Contacts:

CDC has set a 2020 national target of initiating treatment for 91.0% of people diagnosed with latent TB infection found during contact investigations.  The most recent national average was 72.6%.

The National TB Indicators Report contains additional details on latent TB infection treatment initiation rates for states and cities.

Treatment Completion Among Contacts:

CDC has set a 2020 national target of treatment completion for 81.0% of people diagnosed with latent TB infection found during contact investigations who started treatment.  The most recent national average was 75.3%.

The National TB Indicators Report contains additional details on latent TB infection treatment completion rates for states and cities.