The long-term decline in tuberculosis (TB) incidence in the United States showed signs of slowing last year, US officials said today, as the World Health Organization (WHO) called for increasing efforts to meet an ambitious goal of reducing global TB cases by 90% in 20 years.
The statements were released in connection with World TB Day, which will be observed Mar 24.
US incidence down 2.2%
In the United States, the National TB Surveillance System charted a drop in TB cases and rates in 2014, with a total of 9,412 cases and a 2.2% decline in the rate from 2013, to 3.0 cases per 100,000 population, the Centers for Disease Control and Prevention (CDC) reported today.
The agency said the 2.2% decline in incidence was the smallest decrease in more than a decade. The current rate falls well short of the goal of TB elimination, defined as 1 case per 1 million people, set in 1989 and reaffirmed in 1994.
The CDC also noted that the TB burden continues to fall heavily on foreign-born persons and minorities. Of the 9,412 cases in 2014, 6,181 were in foreign-born residents. TB incidence was 13 times higher in the foreign-born than in US-born residents, marking a continued increase in this disparity. Compared with whites, TB incidence was 29 times higher in Asians and 8 times higher in both blacks and Hispanics.
The CDC also reported that multidrug-resistant TB (MDR-TB) accounted for 1.3% of US cases in 2013 and that one case of extensively drug-resistant TB was reported in 2014.
"TB elimination in the U.S. will require increased focus on affected populations and improved awareness, testing, and treatment of TB infection and disease," the agency said.
WHO seeks global solidarity
Meanwhile, the WHO today called for global solidarity and action to progress toward the long-range goal of reducing TB deaths by 95% and cases by 90% by 2035. The goal was set by the World Health Assembly last year.
The WHO said 1.5 million people still die of TB each year. In 2013, as reported previously, 9 million people contracted TB, and almost half a million of those had MDR-TB, the agency noted in a statement.
TB often is economically devastating for families, the WHO noted. Accordingly, the agency seeks to eliminate catastrophic costs for TB patients and their families within the next 5 years by making care more accessible and by providing financial protection to minimize medical and non-medical costs as well as income loss.
"The progress that has been made in combating TB has been hard won and must be intensified if we are to wipe out the TB epidemic," Eric Goosby, MD, UN Special Envoy on TB, said in the WHO statement. "The End TB Strategy offers new hope to the millions of people suffering and losing their lives to TB each year. It is time to join forces to create a world free of TB."
The WHO also called for action to address persistent funding gaps of $2 billion for TB interventions and $1.39 billion for research.
See also:
Mar 20 MMWR article on US TB trends
Mar 19 WHO statement
Related Oct 22, 2014, CIDRAP News story
Mar 17 CIDRAP News scan on TB in Europe
