2019 Contact Investigations Report (ARPE Data)

Table of Contents

Appendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2015-2019.

Table 1: Counts of Smear-Positive Cases and Contacts.

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

Table 3: Contact Investigation Evaluation Indices, 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 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 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 AFB smear-positive TB cases who have started treatment for LTBI, increase the proportion who complete treatment to 93.0% by 2025.
  5. Number of contacts to AFB smear-positive TB cases.
  6. Treatment outcomes for contacts diagnosed with LTBI.

Appendix B. Counts and Indices for Investigation of Sputum AFB Smear-Negative, Culture-Positive TB Cases, 2015-2019.

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

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

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

Appendix C. Counts and Indices for Investigation of Other* Cases, 2015-2019.

Table 7: Counts of Contacts, Other Cases.

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

Table 9: Contact Investigation Evaluation Indices, Other Cases.

Appendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2015-20191

Table 1: Counts of Smear-Positive Cases and Contacts

Appendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2015-20191
Cases and Contacts 2015 2016 2017 2018 2019
Cases for investigation 3,714 3,477 3,364 3,399 3,465
Cases, no contacts 227 188 251 189 194
Number contacts 64,509 59,721 51,392 53,780 51,013
Evaluated 51,294 47,361 41,246 42,075 38,536
TB disease 387 339 415 351 344
Latent TB infection 8,126 7,166 6,418 6,038 5,537
Started treatment 5,904 5,242 4,926 4,553 4,242
Completed treatment 4,468 4,131 3,794 3,606 3,389
Unknown/Missing 302 238 224 354 290

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

Table 2: Reasons Contacts Stopped LTBI Treatment, Smear-Positive Cases
Reason 2015 2016 2017 2018 2019
Contacts stopping treatment (n) 1134 873 908 593 563
Active TB developed 14 (1%) 17 (2%) 7 (1%) 4 (1%) 4 (1%)
Adverse effect of medicine 107 (9%) 103 (12%) 53 (6%) 48 (8%) 47 (8%)
Contact chose to stop 444 (39%) 335 (38%) 299 (33%)   256 (­­­43%) 188 (33%)
Contact lost to follow-up 418 (37%) 291 (33%) 414 (46%)   193 (33%) 248 (44%)
Contact moved (follow-up unknown)  77 (7%) 62 (7%) 67 (7%) 37 (6%) 38 (7%)
Death 6 (1%) 5 (1%) 6 (1%) 4 (1%) 7 (1%)
Provider decision 68 (6%) 60 (7%) 62 (7%) 51 (9%) 31 (6%)

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

Table 3: Contact Investigation Evaluation Indices, Smear-Positive Cases
Evaluation Indices (%) 2015 2016 2017 2018 2019
Contact Elicitation (%) 93.9% 94.6% 92.5% 94.4% 94.4%
Contacts Per Case (N, Average) 17.4 17.2 15.3 15.8 14.7
Contact Evaluation (%) 79.5% 79.3% 80.3% 78.2% 75.5%
TB Disease (%) 0.8% 0.7% 1.0% 0.8% 0.9%
Latent TB Infection (%) 15.8% 15.1% 15.6% 14.4% 14.4%
LTBI Treatment Initiated (%) 72.7% 73.2% 76.8% 75.4% 76.6%
LTBI Treatment Completed (%) 75.7% 78.8% 77.0% 79.2% 79.9%

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. Data shown in tables and figures is up to date as of August 10, 2021.

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, 2015-20192

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 2015 2016 2017 2018 2019
Cases for investigation 1,845 1,932 1,827 1,903 1,783
Cases, no contacts 260 401 312 258 257
Number contacts 17,680 13,914 14,100 13,589 12,674
Evaluated 13,235 11,460 11,627 10,702 9,900
TB disease 78 60 72 72 62
Latent TB infection 1,609 1,493 1,319 1,428 1,144
Started treatment 1,015 965 889 958 744
Completed treatment 737 765 702 744 602
Unknown/Missing 74 4 44 43 34

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 2015 2016 2017 2018 2019
Contacts stopping treatment (n) 204 196 143 171 108
Death 1 (<1%) 1 (1%) 1 (1%) 4 (2%) 2 (2%)
Contact moved 19 (9%) 22 (11%) 17 (12%) 18 (11%) 13 (12%)
Active TB developed 101 (50%) 79(40%) 49 (34%) 71 (42%) 38 (35%)
Adverse effect of medication 57 (28%) 50 (26%) 44 (31%) 54 (32%) 42 (39%)
Contact chose to stop 17 (8%) 20 (10%) 15 (10%) 10 (6%) 6 (6%)
Contact is lost to follow-up 0 (0%) 2 (1%) 1 (1%) 2 (1%) 4 (4%)
Provider decision 9 (4%) 22 (11%) 16 (11%) 12 (7%) 3 (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 (%) 2015 2016 2017 2018 2019
Contact Elicitation (%) 85.9% 79.2% 82.9% 86.4% 85.6%
Contacts Per Case (N, Average) 9.6 7.2 7.7 7.1 7.1
Contact Evaluation (%) 74.9% 82.4% 82.5% 78.8% 78.1%
TB Disease (%) 0.6% 0.5% 0.6% 0.7% 0.6%
Latent TB Infection (%) 12.2% 13.0% 11.3% 13.3% 11.6%
LTBI Treatment Initiated (%) 63.1% 64.6% 67.4% 67.1% 65.0%
LTBI Treatment Completed (%) 72.6% 79.3% 78.9% 77.7% 80.9%

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. Data shown in tables and figures is up to date as of 10 August 2021.

Appendix C. Counts and Indices for Investigation of Other* Cases, 2015-20193

* 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 2015 2016 2017 2018 2019
Number contacts 11,753 8,119 7,936 10,660 8,281
Evaluated 9,879 6,648 6,760 8,814 6,166
TB disease 33 52 62 68 66
Latent TB infection 1,168 847 721 820 793
Started treatment 789 587 531 566 547
Completed treatment 604 454 427 485 451
Unknown/Missing 36 17 25 15 25

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

Table 8: Reasons Contacts Stopped Treatment for LTBI, Other Cases
Reason 2015 2016 2017 2018 2019
Contacts stopping treatment (n) 149 116 79 66 71
Death 0 (0%) 3 (3%) 4 (5%) 1 (2%) 0 (0%)
Contact moved 11 (7%) 11 (10%) 5 (6%) 9 (14%) 14 (20%)
Active TB developed 58 (39%) 46 (40%) 31 (39%) 18 (27%) 27 (38%)
Adverse effect of medication 55 (37%) 27 (23%) 26 (33%) 26 (39%) 21 (30%)
Contact chose to stop 11 (7%) 18 (16%) 8 (10%) 5 (8%) 6 (8%)
Contact is lost to follow-up 1 (1%) 0 (0%) 0 (0%) 1 (2%) 0 (0%)
Provider decision 13 (9%) 11 (9%) 5 (6%) 6 (9%) 3 (4%)

Table 9: Contact Investigation Evaluation Indices, Other Cases

Table 9: Contact Investigation Evaluation Indices, Other Cases
Evaluation Indices (%) 2015 2016 2017 2018 2019
Contact Evaluation (%) 84.1% 81.9% 85.2% 82.7% 74.5%
TB Disease (%) 0.3% 0.8% 0.9% 0.8% 1.1%
Latent TB Infection (%) 11.8% 12.7% 10.7% 9.3% 12.9%
LTBI Treatment Initiated (%) 67.6% 69.3% 73.6% 69.0% 68.9%
LTBI Treatment Completed (%) 76.6% 77.3% 80.4% 85.7% 82.4%

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. Data shown in tables and figures is up to date as of 10 August 2021.