Tennessee Department of Health Observes World TB Day

The Department of Health will join health providers around the globe in observing World TB Day March 24. This annual worldwide health observance is designed to raise awareness and knowledge about tuberculosis, a disease which kills more than 1.5 million people worldwide every year and remains a significant public health concern across the United States and in Tennessee. Tennessee’s minority populations are particularly burdened with TB.

“We know there is a marked TB disparity among minority populations in our state, and it is critical that those who are at high risk for TB get tested to prevent further spread of this infectious disease,” said Tennessee Health Commissioner Susan R. Cooper, MSN, RN. “This treatable, curable and preventable illness must be recognized as a public health concern among these communities.”

Cases of multi-drug resistant TB made news headlines worldwide in the past year, bringing increased awareness to this disease. The World Health Organization has noted that no country is TB-free. In the U.S., approximately 14,000 people develop active TB each year. In 2007, 234 active TB cases were diagnosed in Tennessee.

1. Racial and ethnic minorities accounted for 64 percent of Tennessee’s TB cases in 2007. Although non-Hispanic blacks make up less than 17 percent of the state’s population, they represented 40 percent of all cases reported in 2007. Department of Health statistics show non-Hispanic blacks were five times more likely to be diagnosed with active TB in 2007 than non-Hispanic whites. In comparison, Hispanics made up only 15 percent of Tennessee’s TB cases in 2007, but they were 10 times more likely to be diagnosed with active TB in 2007 than non-Hispanic whites.

“The high burden of TB in minority populations is due to a number of causes, such as being born in a country where TB is common and the disproportionate level of TB risk factors among these communities, particularly HIV infection,” said Tennessee TB Control Officer Jon Warkentin, MD.

Persons at high risk for TB include individuals born in countries that have high rates of TB, persons with HIV infection and AIDS, homeless persons, people who have spent time in jail or prison, intravenous drug users, and those who have had close interactions with persons who have infectious TB disease.

Progress is being made in efforts to reduce TB cases. In 2005, the rate of new cases of TB worldwide leveled off for the first time since the WHO began collecting data on the disease. The rate at which TB is detected has doubled since 2000. Despite such progress, TB remains a massive global health problem, with nearly nine million new cases each year. WHO and the Stop TB Partnership estimate that two billion people, equal to one-third of the world’s population, are infected with the TB germ.

“We will never eliminate TB without new and more effective drugs, diagnostics and vaccines,” said Warkentin. “Greater commitment to financing TB care and research to develop new treatments is urgently needed.”

Cherry L. Houston, PhD, MPH, RN, director of the Division of Minority Health and Health Disparities Elimination, also emphasizes the need to focus on social issues that contribute to TB infection and risk factors for the disease.

1. “Unless we also focus on creating partnerships that address poverty, joblessness, homelessness, poor education and all the factors that make people more susceptible to this disease, we will continue on this road of ill health “ said Houston.

TB usually affects the lungs, but it can also affect other parts of the body such as the brain, kidneys or spine. Symptoms of TB in lungs may include a persistent cough for three or more weeks, chest pain and coughing up blood. Other general symptoms of active TB include loss of appetite, weakness, weight loss, fever and night sweats. If active TB is not treated quickly and appropriately, the disease can be fatal.

The Tennessee Department of Health recommends individuals who are at high risk for TB have a skin test to find out if they have TB infection. All local health departments across the state offer free TB risk screening, confidential skin testing and treatment for those at high risk for infection. A list of local health departments is available at http://health.state.tn.us/localdepartments.htm, or you may call the Division of Minority Health and Disparities Elimination toll-free at 1-877-606-0089 to find the nearest county health department location. Effective treatment is available to those infected with the TB bacterium, which significantly reduces the chance of developing active TB disease in the future.

To learn more about TB in Tennessee, visit the Department of Health’s Web site at
http://health.state.tn.us/CEDS/TB/index.htm.