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Washington State Cohort Review 2009 trends & 1 st quarter

Washington State Cohort Review 2009 trends & 1 st quarter. Washington State Department of Health April 14, 2010. Tuberculosis Incidence Rate, 2000 - 2009 . National. WA State. 7.0. 6.0. 5.0. 4.0. 3.0. 2.0. 1.0. 0.0. 2000. 2001. 2002. 2003. 2004. 2005. 2006. 2007. 2008.

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Washington State Cohort Review 2009 trends & 1 st quarter

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  1. Washington State Cohort Review2009 trends & 1st quarter Washington State Department of Health April 14, 2010

  2. Tuberculosis Incidence Rate, 2000 - 2009 National WA State 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Annual TB Case Rates

  3. Highlights of 2009 trends • 12.3% increase in number of TB cases in 2009: 228 to 256 • TB case rate: increased from 3.5 in 2008 to 3.8 in 2009(per 100,000 individuals) • Also in 2009: • Started data management in PHIMS • All time low TB case rate reported in WA in 2008

  4. 2009 TB Case Rates by County • Largest increase: Clark Co. (1.7 to 3.7) • Largest decrease: Yakima Co. (4.7 to 2.1) • Top 5 case rates: • King: 6.8 • Pierce: 4.2 • Snohomish: 4.0 • Clark: 3.7 • Thurston 3.2

  5. 2009 TB Cases by demographics • By race/ethnicity: • Largest increase in Asians (18.6 to 24.7) • Largest decrease in AI/AN (6.3 to 4.2) • 78% foreign born (continued trend in increase) • Decrease in proportion of pediatric cases • Increase in proportion of 45+ y.o. cases

  6. Trend in Age (2004 -2009)

  7. Trend in Age in Foreign-born cases (2004 – 2009)

  8. Trend in Age in US born cases (2004 – 2009)

  9. In progress… • Further analysis on timeliness!

  10. Distribution of 2009 cases by Quarter and County

  11. Quarter 1 (Jan – Mar) of 2009 Highlights for Outside King co.

  12. CASES: Treatment Hx • TOTAL: 18 cases • No pediatric cases • 100% initiation on tx • DOT 83% of all (100% of Sm+ case) • 67% total DOT • 17% DOT in combination with self-admn • 6% HIV testing not offered: • 1 Sm-Cul+ case

  13. CASES: Tx completion • 83% likely to complete • 78% completed • 6% currently on • 17% moved: • 1 Sm-Cul+ case • 2 ‘other’ cases • 0% lost

  14. Timeliness (Median number of days) • Start of Meds: 1 day • Lab sputum collection: 0 (same day) • Culture testing: 20.5 days • HCP to LHJ: same day • Lab to LHJ: same day • LHJ to DOH: 1 day • Susceptibility: 20.5 days • Sm+ date to contact identification: -2.5

  15. Contacts: Jan – Mar 2009 • 86 contacts identified for 18 cases • 87% tested • 64% evaluated • 17% infected • 0% diseased

  16. Contacts: Tx history • 8% (1 of 13) of infected didn’t start tx • 20 contacts started treatment: • 60% infected • 40% not infected • 55% completed tx • 5% refused tx • 0% lost, died, moved, provider disc.

  17. Thank you!

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