Tuberculosis Surveillance Annual Report, 2023

Tuberculosis, caused by Mycobacterium tuberculosis bacteria, poses a significant public health concern. The 2023 annual report for Rhode Island reveals a rise in active TB cases, particularly among foreign-born individuals. Providence County reported the highest rates. The data highlights age and gender disparities in TB infection rates. Understanding these trends is crucial for effective TB management and prevention strategies.

• Tuberculosis
• Surveillance Report
• Rhode Island
• Public Health
• Disease Management

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1. Tuberculosis Surveillance Annual Report, 2023

2. About Tuberculosis Tuberculosis (TB) is caused by the Mycobacterium tuberculosis bacteria. TB bacteria are spread through the air and are transmitted by those with infectious active disease in the lungs or throat (pulmonary TB). Symptoms of active pulmonary TB disease include cough, fever, night sweats, hemoptysis (coughing up blood), and weight loss. It is estimated that ~15% of foreign-born persons have latent TB infection (LTBI). Those with LTBI have no symptoms and cannot spread TB bacteria. About 5-10% of people with LTBI will develop active TB disease in their lifetime; treatment reduces this risk.

3. Data Overview, Tuberculosis in Rhode Island 2023 In 2023, there were 27 cases of active TB in Rhode Island 81% foreign-born The incidence rate was 2.5 cases of active disease per 100,000 population Cases increased 286% since 2020 Cases increased 59% since 2021 and 2022 Annually, the highest rates of TB disease are seen in Providence County

4. Reported Cases of Tuberculosis, Rhode Island, 2014-2023 Cases Rate 35 3.5 30 3.0 2.9 25 2.5 2.5 Rate per 100,000 Number of Cases 20 2.0 2.0 1.8 1.6 1.6 15 1.5 1.3 1.2 1.1 10 1.0 0.7 5 0.5 21 30 12 13 19 14 7 17 17 27 0 0.0 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Figure 1. In 2023, there were 27 cases of Active Tuberculosis in Rhode Island, at a rate of 2.5 cases per 100,000 population. This is the highest rate of TB reported since 2015.

5. Rate of Tuberculosis, by Age Group, Rhode Island, 2023 4.0 3.5 3.5 3.2 3.0 Rate per 100,000 2.5 2.0 2.0 1.5 1.5 1.2 1.0 0.5 0.0 0-14 15 24 25 44 45 64 65 + Figure 2. In 2023, the highest rates of active Tuberculosis were seen in adults aged 45-65, at a rate of 3.5 cases per 100,000 population. The second highest rate of infection was among the 25-44 age group, at 3.2 cases per 100,000. In 2023, there were 5 reported cases under the age of 25.

6. Rate of Tuberculosis, by Sex, Rhode Island, 2019-2023 Female Male 3.0 2.8 2.5 2.5 2.1 2.0 Rate per 100,000 1.7 1.5 1.4 1.5 1.2 1.0 1.0 0.7 0.5 0.4 0.0 2019 2020 2021 2022 2023 Figure 3. Since 2020 rates of TB have been higher in males compared to females.

7. Rate of Tuberculosis, by County, Rhode Island, 2019-2023 Bristol Kent Newport Providence Washington 4.5 4.0 4.0 3.5 Rate per 100,000 3.0 2.5 2.5 2.2 2.0 2.0 1.6 1.5 1.2 1.2 1.2 1.2 1.1 0.8 1.0 0.6 0.5 0.0 2019 2020 2021 2022 2023 Figure 4. Providence County typically has the highest rate of reported TB compared to all other counties.

8. Rate of Tuberculosis, by Race/Ethnicity, Rhode Island, 2019-2023 Non-Hispanic White Non-Hispanic Black Asian Hispanic or Latino 25.0 20.6 20.2 20.0 Rate per 100,000 15.0 11.6 11.6 9.1 10.0 6.1 5.8 4.4 4.0 5.0 2.9 2.7 2.0 1.5 1.5 1.3 0.8 0.4 0.4 0.1 0.0 0.0 2019 2020 2021 2022 2023 Figure 5. Rates of TB are consistently highest in the Asian population compared to Hispanic or Latino, non-Hispanic white, and non-Hispanic black populations.

9. Tuberculosis Frequency and Rate, Rhode Island, 2014-2023 Table 1. Frequency and Rate, Rhode Island 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 27 Cases 21 30 12 13 19 14 7 17 17 Rate 2.0 2.9 1.1 1.2 1.8 1.3 0.7 1.6 1.6 2.5

10. Tuberculosis Frequency & Rate by Age Group, Rhode Island, 2019-2023 Table 2. Frequency by Age Group and Year 2019 2020 2021 2022 2023 0-14 0 0 <5 <5 <5 15-24 0 0 <5 6 <5 25-44 6 <5 <5 <5 9 45-64 <5 <5 7 <5 10 >65 <5 <5 <5 <5 <5 Table 3. Rate by Age Group and Year 2019 2020 2021 2022 2023 0-14 0.0 0.0 0.0 0.0 0.6 0.6 0.6 3.9 1.2 2.0 15-24 25-44 2.3 1.1 1.5 1.4 3.2 45-64 1.4 0.3 2.4 1.4 3.5 >65 2.4 1.8 2.4 1.0 1.5

11. Tuberculosis Frequency and Rate, by Sex, Rhode Island, 2019-2023 Table 4. Frequency by Sex and Year 2019 2020 2021 2022 2023 12 <5 <5 8 8 Female 15 6 5 13 9 Male Table 5. Rate by Sex and Year 2019 2020 2021 2022 2023 1.4 2.1 1.5 0.4 0.7 Female 1.7 2.8 1.2 1.0 2.5 Male

12. TB Frequency, by Race/Ethnicity, Rhode Island, 2019-2023 Table 6. Frequency by Race/Ethnicity and Year 2019 2020 2021 2022 2023 Hispanic <5 <5 17 8 6 Non-Hispanic White <5 <5 <5 <5 0 Non-Hispanic Black <5 <5 <5 <5 0 Asian <5 <5 17 8 6 American 0 0 0 0 0 Indian/Alaska Native Hawaii Native/Other Pacific Islander <5 0 0 0 0 <5 Multi or Other Race 0 0 0 0

13. TB Rate, by Race/Ethnicity, Rhode Island, 2019-2023 Table 7. Rates by Race/Ethnicity and Year 2019 2020 2021 2022 2023 Hispanic 2.7 1.3 6.1 4.0 9.1 Non-Hispanic White 0.8 0.0 0.1 0.4 0.4 Non-Hispanic Black 2.0 4.4 2.9 1.5 1.5 Asian 20.6 20.2 5.8 11.6 11.6 American 0.0 0.0 0.0 0.0 0.0 Indian/Alaska Native Hawaii Native/Other Pacific Islander 0.0 131.9 0.0 0.0 0.0

14. Tuberculosis Frequency and Rate, by County, Rhode Island, 2019-2023 Table 8. Frequency by County and Year 2019 2020 <5 0 <5 0 <5 0 10 7 0 0 2021 0 <5 0 16 0 2022 0 <5 0 14 <5 2023 0 0 <5 26 0 Bristol Kent Newport Providence Washington Table 9. Rate by County and Year 2019 2020 2.0 0.0 1.2 0.0 1.2 0.0 1.6 1.1 0.0 0.0 2021 0.0 0.6 0.0 2.5 0.0 2022 0.0 1.2 0.0 2.2 0.8 2023 0.0 0.0 1.2 4.0 0.0 Bristol Kent Newport Providence Washington

15. Data Sources Rates are expressed as cases per 100,000 population. Rates for years 2014-2016 were calculated using the population of Rhode Island as determined by the 2010 U.S. Census; rates for years 2017-2021 were calculated using the population of Rhode Island as determined by the 2016 U.S. RI Census Estimate; rates for years 2022-2023 were calculated using the population of Rhode Island as determined by the 2021 1-Year ACS. Notes: Values less than five are suppressed for confidentiality. If these data are used in a publication, please acknowledge the RI Department of Health, Division of Emergency Preparedness and Infectious Disease. CONFIDENTIALITY NOTICE: This data is privileged, confidential, and/or otherwise protected from disclosure to anyone other than its intended recipient(s). Any dissemination or use of this data or its contents by persons other than the intended recipient(s) is strictly prohibited.

16. Updated: May 2024 Rhode Island Department of Health Division of Emergency Preparedness & Infectious Disease Center for HIV, Hepatitis, STD, and TB Epidemiology