2020 Contact Investigations Report (ARPE Data)

Table of Contents

Appendix A. Counts and Indices for Investigation of Sputum Acid-fast Bacillus (AFB) Smear-Positive TB Cases, 2017-2021

Table 1: Counts of Sputum AFB Smear-Positive Cases and Contacts

Table 2: Reasons Contacts Stopped Latent TB Infection Treatment, Sputum AFB Smear-Positive Cases

Table 3: Contact Investigation Evaluation Indices, Sputum AFB Smear-Positive Cases

Figures

  1. National Objective: Increase the proportion of TB patients with positive acid-fast bacillus (AFB) sputum-smear results who have contacts elicited to 100.0% by 2025
  2. National Objective: Increase the proportion of contacts to sputum acid-fast bacillus (AFB)smear-positive TB cases who are examined for infection and disease to 94.0% by 2025
  3. National Objective: Increase the proportion of contacts to sputum acid-fast bacillus (AFB) smear-positive TB cases diagnosed with latent TB Infection (LTBI) who start treatment to 92.0% by 2025
  4. National Objective: For contacts to sputum acid-fast bacillus (AFB) smear-positive TB cases who have started treatment for latent TB infection (LTBI), increase the proportion who complete treatment to 93.0% by 2025
  5. Number of Contacts to Sputum acid-fast bacillus (AFB) Smear-Positive TB Cases

Appendix B. Counts and Indices for Investigation of Sputum Acid-fast Bacillus (AFB) Smear-Negative, Culture-Positive TB Cases, 2017-2021

Table 4: Counts of Sputum AFB Smear-Negative, Culture-Positive Cases and Contacts

Table 5: Reasons Contacts Stopped Latent TB Infection Treatment Sputum AFB Smear-Negative, Culture-Positive Cases

Table 6: Contact Investigation Evaluation Indices Sputum AFB Smear-Negative, Culture-Positive Cases

Appendix C. Counts and Indices for Investigation of Other* Cases, 2017-2021

Table 7: Counts of Contacts, Other Cases

Table 8: Reasons Contacts Stopped Treatment for Latent TB Infection, Other Cases

Table 9: Contact Investigation Evaluation Indices, Other Cases

Appendix A. Counts and Indices for Investigation of Sputum Acid-fast Bacillus (AFB) Smear-Positive TB Cases, 2017-20211

Table 1: Counts of Smear-Positive Cases and Contacts

Appendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2015-2019
Cases and Contacts 2017 2018 2019 2020 2021
Cases for investigation 3364 3398 3481 2879 3320
Cases, no contacts 247 187 193 206 270
Number of contacts 51447 53783 51419 35915 27202
Evaluated 41489 42302 38942 28095 20738
TB disease 416 352 345 317 381
Latent TB infection 6428 6044 5587 4229 4438
Started treatment 4952 4583 4271

3290

3272
Completed treatment 3804 3623 3423 2600 2657
Treatment outcome unknown/missing 231 366 283 335 263

Table 2: Reasons Contacts Stopped LTBI Treatment, Smear-Positive Cases

Table 2: Reasons Contacts Stopped LTBI Treatment, Smear-Positive Cases
Reason 2016 2017 2018 2019 2020
Contacts stopping treatment (n) 873 908 595 563 365
Active TB developed 17 (2%) 7 (1%) 5 (<1%) 4 (1%) 2 (<1%)
Adverse effect of medicine 103 (12%) 53 (6%) 48 (8%) 47 (8%) 38 (10%)
Contact chose to stop 335 (38%) 299 (33%) 257 (43%) 188 (33%) 113 (31%)
Contact lost to follow-up 291 (33%) 414 (46%)   193 (33%) 248 (44%) 146 (40%)
Contact moved (follow-up unknown) 62 (7%) 67 (7%) 37 (6%) 38 (7%) 28 (8%)
Death 5 (1%) 6 (1%) 4 (1%) 7 (1%) 13 (4%)
Provider decision 60 (7%) 62 (7%) 51 (9%) 31 (6%) 25 (7%)

Table 3: Contact Investigation Evaluation Indices, Smear-Positive Cases

Table 3: Contact Investigation Evaluation Indices, Smear-Positive Cases
Evaluation Indices (%) 2016 2017 2018 2019 2020
Contact Elicitation (%) 94.6% 92.5% 94.4% 94.4% 92.9%
Contacts Per Case (N, Average) 17.2 15.3 15.8 14.8 12.5
Contact Evaluation (%) 79.3% 80.3% 78.2% 75.6% 77.5%
TB Disease (%) 0.7% 1.0% 0.8% 0.9% 1.1%
Latent TB Infection (%) 15.1% 15.6% 14.4% 14.4% 15.3%
LTBI Treatment Initiated (%) 73.2% 76.8% 75.6% 76.4% 77.4%
LTBI Treatment Completed (%) 78.8% 77.0% 79.2% 80.1% 79.0%

1Reporting jurisdictions: 50 U.S. states, Washington D.C., Puerto Rico and eight large city jurisdictions (Los Angeles, CA, San Francisco, CA, San Diego, CA, Chicago, IL, Baltimore, MD, New York City, NY, Philadelphia, PA, Houston, TX). Missouri did not report in 2017 and 2018, and Kansas did not report in 2016 -2018. Nebraska, and Virgin Islands did not report in 2018. Vermont did not report in 2019. Iowa did not report in 2020. Data shown in tables and figures are up to date as of July 11, 2022

Figures

1. National Objective:  Increase the proportion of TB patients with positive acid-fast bacillus (AFB) sputum-smear results who have contacts elicited to 100.0% by 2025.

Objective: Increase the proportion of TB patients with positive acid-fast bacillus (AFB) sputum-smear results who have contacts elicited to 100.0% by 2025.

Indicator: Percent of sputum AFB smear-positive TB cases with contacts elicited.

Cohort: Sputum AFB smear-positive TB cases counted in the cohort period of interest. Records with missing or incomplete data where exclusion criteria cannot be assessed are included in the analytic cohort.

Data Sources: ARPEs (Contacts) fields, a1 (Sputum smear+ Cases for Investigation), b1 (Sputum smear+ Cases with No Contacts).

Sputum AFB smear-positive TB Cases with contacts elicited = Number of sputum AFB smear-positive TB cases for investigation – Number of sputum AFB smear-positive TB cases with no contacts.

Calculation: [(Number of sputum AFB smear-positive TB cases with contacts elicited) / Cohort] x 100.

2. National Objective:  Increase the proportion of contacts to sputum AFB smear-positive TB cases who are examined for infection and disease to 94.0% by 2025.

 

Objective: Increase the proportion of contacts to sputum AFB smear-positive TB cases who are examined for infection and disease to 94.0% by 2025.

Contacts are counted as evaluated if they have been tested and examined to the point where a final determination of diagnosis is either latent TB infection or TB disease.

Indicator: Percent of contacts to sputum AFB smear-positive TB cases examined for infection and disease.

Cohort: Contacts to sputum AFB smear-positive TB cases counted in the cohort period of interest. Records with missing or incomplete data where exclusion criteria cannot be assessed are included in the analytic cohort.

Data Sources: ARPEs (Contacts) fields, c1 (Number of Contacts to Sputum smear+ Cases), d1 (Contacts to Sputum smear+ Cases Evaluated).

Calculation: [Number of contacts to sputum AFB smear-positive TB cases evaluated / Cohort] x 100.

3. National Objective:  Increase the proportion of contacts to sputum AFB smear-positive TB cases diagnosed with latent TB infection (LTBI) who start treatment to 92.0% by 2025.

Objective: Increase the proportion of contacts to sputum acid-fast bacillus (AFB) smear-positive TB cases diagnosed with latent TB infection (LTBI) who start treatment to 92.0% by 2025.

Indicator: Percent of contacts to sputum AFB smear-positive TB cases diagnosed with LTBI who started treatment NOTE: Contacts are counted as having started treatment after taking the first dose of a treatment course.

Cohort: Contacts to sputum AFB smear-positive TB cases who have newly diagnosed LTBI, counted in the cohort period of interest. Records with missing or incomplete data where exclusion criteria cannot be assessed are included in the analytic cohort.

Data Sources: ARPEs (Contacts) fields, f1 (Contacts to Sputum smear+ Cases with Latent TB Infection), g1 (Contacts to Sputum smear+ Cases Diagnosed with Latent TB Infection Who Started Treatment).

Calculation: [Number of contacts diagnosed with LTBI who started treatment / Cohort] x 100.

4. National Objective:  For contacts to sputum AFB smear-positive TB cases who have started treatment for LTBI, increase the proportion who complete treatment to 93.0% by 2025.

Objective: For contacts to sputum AFB smear-positive TB cases who have started treatment for LTBI, increase the proportion who complete treatment to 93.0% by 2025.

Indicator: Percent of contacts to sputum AFB smear-positive TB cases who completed treatment.

Cohort: Contacts to sputum AFB smear-positive TB cases with newly diagnosed LTBI and have started treatment, counted in the cohort period of interest. Records with missing or incomplete data where exclusion criteria cannot be assessed are included in the analytic cohort.

Data Sources: ARPEs (Contacts) fields, g1 (Contacts to Sputum smear+ Cases Diagnosed with Latent TB Infection Who Started Treatment), h1 (Contacts to Sputum smear+ Cases Diagnosed with Latent TB Infection Who Completed Treatment).

Calculation: [Number of contacts diagnosed with LTBI who completed treatment / Cohort] x 100.

5. Number of contacts to AFB smear-positive TB cases

Number of Contacts to Sputum Acid-Fast Bacillus (AFB) Smear-Positive TB Cases, by Examination and Treatment Disposition, United States 2018

6. Treatment outcomes for contacts diagnosed with LTBI

Treatment Outcomes for Contacts to Sputum Acid-Fast Bacillus Smear-Positive TB Cases Diagnosed with Latent TB Infection (LTBI), United States 2018

Appendix B. Counts and Indices for Investigation of Sputum AFB Smear-Negative, Culture-Positive TB Cases, 2016-20202

Table 4: Counts of Smear-Negative, Culture-Positive Cases and Contacts

Table 4: Counts of Smear-Negative, Culture-Positive Cases and Contacts
Cases and Contacts 2016 2017 2018 2019 2020
Cases for investigation 1,932 1,827 1,903 1,784 1333
Cases, no contacts 401 312 258 257 205
Number contacts 13,914 14,100 13,589 12,679 8795
Evaluated 11,460 11,627 10,703 9,905 6893
TB disease 60 72 72 63 66
Latent TB infection 1,493 1,319 1,427 1,146 896
Started treatment 965 889 959 746 562
Completed treatment 765 702 744 606 407
Treatment outcome unknown/missing 4 44 43 32 92

Table 5: Reasons Contacts Stopped LTBI Treatment – Smear-Negative, Culture-Positive Cases

Table 5: Reasons Contacts Stopped LTBI Treatment – Smear-Negative, Culture-Positive Cases
Reason 2016 2017 2018 2019 2020
Contacts stopping treatment (n) 196 143 172 108 63
Active TB developed 1 (1%) 1 (1%) 4 (2%) 2 (2%) 0 (0%)
Adverse effect of medicine 22 (11%) 17 (12%) 18 (10%) 13 (12%) 12 (19%)
Contact chose to stop 79(40%) 49 (34%) 71 (41%) 38 (35%) 25 (40%)
Contact lost to follow-up 50 (26%) 44 (31%) 55 (32%) 42 (39%) 19 (30%)
Contact moved (follow-up unknown) 20 (10%) 15 (10%) 10 (6%) 6 (6%) 3 (5%)
Death 2 (1%) 1 (1%) 2 (1%) 4 (4%) 2 (3%)
Provider decision 22 (11%) 16 (11%) 12 (7%) 3 (3%) 2 (3%)

Table 6: Contact Investigation Evaluation Indices – Smear-Negative, Culture-Positive Cases

Table 6: Contact Investigation Evaluation Indices – Smear-Negative, Culture-Positive Cases
Evaluation Indices (%) 2016 2017 2018 2019 2020
Contact Elicitation (%) 79.2% 82.9% 86.4% 85.6% 84.6%
Contacts Per Case (N, Average) 7.2 7.7 7.1 7.1 6.6
Contact Evaluation (%) 82.4% 82.5% 78.8% 78.1% 78.4%
TB Disease (%) 0.5% 0.6% 0.7% 0.6% 0.9%
Latent TB Infection (%) 13.0% 11.3% 13.3% 11.6% 12.9%
LTBI Treatment Initiated (%) 64.6% 67.4% 67.2% 65.1% 62.7%
LTBI Treatment Completed (%) 79.3% 78.9% 77.6% 81.2% 72.4%

2Reporting jurisdictions: 50 U.S. states, Washington D.C., Puerto Rico and eight large city jurisdictions (Los Angeles, CA, San Francisco, CA, San Diego, CA, Chicago, IL, Baltimore, MD, New York City, NY, Philadelphia, PA, Houston, TX). Missouri did not report in 2017 and 2018, and Kansas did not report in 2016 -2018. Nebraska, and Virgin Islands did not report in 2018. Vermont did not report in 2019. Iowa did not report in 2020. Data shown in tables and figures are up to date as of July 11, 2022.

Appendix C. Counts and Indices for Investigation of Other* Cases, 2016-20203

* Other = Contact investigations not captured in investigating sputum AFB smear-positive or sputum AFB smear-negative\culture-positive.  For example:  Associate-contact or source-case investigations done because of a child with TB.

Table 7: Counts of Contacts, Other Cases

Table 7: Counts of Contacts, Other Cases
Contacts 2016 2017 2018 2019 2020
Number contacts 8,119 7,936 10,656 8,284 5605
Evaluated 6,648 6,760 8,810 6,170 4271
TB disease 52 62 68 66 67
Latent TB infection 847 721 821 795 509
Started treatment 587 531 574 549 336
Completed treatment 454 427 492 455 276
Unknown/Missing 17 25 15 25 12

Table 8: Reasons Contacts Stopped Treatment for LTBI, Other Cases

Table 8: Reasons Contacts Stopped Treatment for LTBI, Other Cases
Reason 2016 2017 2018 2019 2020
Contacts stopping treatment (n) 116 79 67 71 48
Active TB developed 3 (3%) 4 (5%) 2 (3%) 0 (0%) 0 (0%)
Adverse effect of medicine 11 (10%) 5 (6%) 9 (13%) 14 (20%) 6 (13%)
Contact chose to stop 46 (40%) 31 (39%) 18 (27%) 27 (38%) 18 (38%)
Contact lost to follow-up 27 (23%) 26 (33%) 26 (39%) 21 (30%) 18 (38%)
Contact moved (follow-up unknown) 18 (16%) 8 (10%) 5 (7%) 6 (8%) 4 (8%)
Death 0 (0%) 0 (0%) 1 (2%) 0 (0%) 0 (0%)
Provider decision 11 (9%) 5 (6%) 6 (9%) 3 (4%) 2 (4%)

Table 9: Contact Investigation Evaluation Indices, Other Cases

Table 9: Contact Investigation Evaluation Indices, Other Cases
Evaluation Indices (%) 2016 2017 2018 2019 2020
Contact Evaluation (%) 81.9% 85.2% 82.7% 74.5% 76.2%
TB Disease (%) 0.8% 0.9% 0.8% 1.1% 1.6%
Latent TB Infection (%) 12.7% 10.7% 9.3% 12.9% 11.9%
LTBI Treatment Initiated (%) 69.3% 73.6% 69.9% 69.1% 66.0%
LTBI Treatment Completed (%) 77.3% 80.4% 85.7% 82.9% 82.1%

3Reporting jurisdictions: 50 U.S. states, Washington D.C., Puerto Rico and eight large city jurisdictions (Los Angeles, CA, San Francisco, CA, San Diego, CA, Chicago, IL, Baltimore, MD, New York City, NY, Philadelphia, PA, Houston, TX). Missouri did not report in 2017 and 2018, and Kansas did not report in 2016 -2018. Nebraska, and Virgin Islands did not report in 2018. Vermont did not report in 2019. Iowa did not report in 2020. Data shown in tables and figures are up to date as of July 11, 2022.