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Tuberculosis (TB)








2020 Contact Investigations Report (ARPE Data)										Related Pages
										Table of Contents
Appendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2016-2020
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
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
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
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
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
Number of contacts to AFB smear-positive TB cases
Treatment outcomes for contacts diagnosed with LTBIAppendix B. Counts and Indices for Investigation of Sputum AFB Smear-Negative, Culture-Positive TB Cases, 2016-2020
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, 2016-2020
Table 7: Counts of Contacts, Other Cases
Table 8: Reasons Contacts Stopped Treatment for LTBI, Other Cases
Table 9: Contact Investigation Evaluation Indices, Other CasesAppendix A. Counts and Indices for Investigation of Sputum AFB Smear-Positive TB Cases, 2016-20201
**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**
**2016**
**2017**
**2018**
**2019**
**2020****Cases for investigation**
3,477
3,364
3,399
3,481
2,858**Cases, no contacts**
188
251
189
194
204**Number contacts**
59,721
51,392
53,779
51,416
35,718**Evaluated**
47,361
41,246
42,075
38,886
27,678**TB disease**
339
415
351
346
313**Latent TB infection**
7,166
6,418
6,038
5,586
4,221**Started treatment**
5,242
4,926
4,567
4,270
3,265**Completed treatment**
4,131
3,794
3,618
3,420
2,580**Treatment outcome unknown/missing**
238
224
354
287
320Top of Page**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%)Top of Page**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, 2022Top of PageFigures
**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.**
Sputum Acid-fast Bacillus (AFB) Smear-positive TB Cases with Contacts Elicited, United States 2014 to 2018View LargerCloseSputum Acid-fast Bacillus (AFB) Smear-positive TB Cases with Contacts Elicited, United States 2014 to 2018Download Image[PNG]
**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.Top of Page**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.**

Examination of Contacts to Sputum Acid-fast Bacillus (AFB) Smear-positive TB Cases, United States 2014 to 2018View LargerCloseExamination of Contacts to Sputum Acid-fast Bacillus (AFB) Smear-positive TB Cases, United States 2014 to 2018Download Image[PNG]
**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.Top of Page**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.**
Contacts to Sputum Acid-Fast Bacillus (AFB) Smear-Positive TB Cases Diagnosed with Latent TB Infection (LTBI) Who Started Treatment, United States, 2014 to 2018View LargerCloseContacts to Sputum Acid-Fast Bacillus (AFB) Smear-Positive TB Cases Diagnosed with Latent TB Infection (LTBI) Who Started Treatment, United States, 2014 to 2018Download Image[PNG]
**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.Top of Page**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.**
Treatment Completion for Contacts to Sputum Acid-Fast Bacillus (AFB) Smear-Positive TB Cases Who Have Started Treatment for Latent TB Infection (LTBI), United States 2014 to 2018View LargerCloseTreatment Completion for Contacts to Sputum Acid-Fast Bacillus (AFB) Smear-Positive TB Cases Who Have Started Treatment for Latent TB Infection (LTBI), United States 2014 to 2018Download Image[PNG]
**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.Top of Page**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 2018Top of Page**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 2018Top of PageAppendix 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
92Top of Page**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%)Top of Page**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.Top of PageAppendix 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
12Top of Page
**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%)Top of Page
**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.Top of Page
							
					
							Last Reviewed:  October 25, 2022						Source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
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