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2019 State and City TB Report										Related Pages
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			OverviewFigure: Percent of New TB Cases Completing TherapyTable: Treatment Completion, Ages ≥15, HomelessTable: Treatment Completion, Ages ≥15, IncarceratedFootnotes
		
Completion of Therapy
Fully treating and, therefore, preventing further spread of *M. tuberculosis* is key to TB control and elimination. If TB drugs are stopped too soon or not taken correctly, a person may develop symptoms again or drug resistance may develop, enabling the further spread of TB. Each patient is unique. There are many reasons why a patient might be unable or unwilling to complete TB treatment, such as:
No longer experiencing symptoms of TB, not fully understanding the treatment regimen
Not being willing or able to manage side effects of their treatment regimen
Cultural beliefs
Language barriers
Difficulty getting health care
Substance use
Mental health issuesCompletion of therapy among persons who have experienced homelessness or been incarcerated can be particularly challenging due to difficulty locating patients for follow-up care and treatment, but is particularly important because of the risk of transmission at shelters or in the jail or prison systems.
2019 State and City ReportFigure 9. Percentage of Newly Diagnosed TB Cases Completing Treatment ≤12 Months, United States, 2017
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Close2019 State and City ReportFigure 9. Percentage of Newly Diagnosed TB Cases Completing Treatment ≤12 Months, United States, 2017
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There are several ways to increase treatment completion. These include:
Directly observed therapy (i.e., patients are observed to ingest each dose of anti-TB medications)
Use of incentives and enablers (e.g., gift cards for food or bus fare for transportation to get to and from the health department) to get patients to complete treatmentTB treatment is complex and can take several months to complete.  It can take up to 2 years to have full treatment information reported for each TB patient.  As a result, the most recent information available on completion of therapy is from patients in the 50 states and 9 cities who were identified with TB in 2017.
For these patients, 20 states and one city met or exceeded the 2025 national target of 95.0% of TB cases completing a full treatment regimen in 12 months or less; 14 states and 2 cities were short of the 2025 target but met or exceeded the national average (89.8%) (Figure 9).
Additionally, in 2017 there were 7 states and 5 cities that reported more than 7 TB patients, ’15 years of age who experienced homelessness in the year prior to diagnosis; 7 of these 12 jurisdictions exceeded the national average of 80.7% completion of therapy among homeless TB patients (Table 1).
There were 8 states and 2 cities in 2017 that reported more than 4 TB patients, 15 years of age or older who were incarcerated at TB diagnosis; 6 of these 10 jurisdictions exceeded the national average of 73.1% completion of therapy among incarcerated TB patients (Table 2).**Table 1. Treatment Completion within 12 Months or Less among Newly Diagnosed TB Patients Age ≥15 who Experienced Homelessness within the Year Prior to Diagnosis, United States, 2017**States with 1 to 3 patientsStates with 4 to 7 patientsState with 8 or more patientsStates with 1 to 3 TB patients age ≥ 15 who were homeless
States*with 1 to 3 TB patients age >15  experiencing homelessness
Percentage of patients age >15 experiencing homelessness who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Connecticut
100.0
98.0New Hampshire
100.0
88.2Pennsylvania
100.0
86.0Wisconsin
100.0
90.0Illinois
100.0
91.6Michigan
100.0
96.0Kansas
100.0
100.0Maryland
100.0
82.6Nevada
100.0
98.5New Jersey
100.0
92.9Louisiana
66.7
82.4Philadelphia
66.7
60.3Alaska
50.0
91.5Missouri
50.0
73.6States with 4 to 7 TB patients age ≥ 15 who were homeless
States* with 4 to 7 TB patients age >15 experiencing homelessness
Percentage of  patients age >15 experiencing homelessness who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Arkansas
100.0
78.9Colorado
100.0
91.2Indiana
100.0
96.4Oregon
100.0
90.2Ohio
100.0
82.3Virginia
100.0
97.2Minnesota
100.0
95.7Mississippi
100.0
86.4Washington
100.0
93.4North Carolina
85.7
93.6Alabama
80.0
87.9New York
80.0
92.6Hawaii
75.0
96.9San Francisco
75.0
88.5District of Columbia
42.9
76.7South Carolina
40.0
92.0**States with 8 or more TB patients age ≥ 15 who were homeless**
States* with 8 or more TB patients age >15 experiencing homelessness
Percentage of  patients age >15 experiencing homelessness who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Massachusetts
100.0
94.6Chicago
100.0
90.6Houston
92.3
85.8Tennessee
91.7
95.2Arizona
84.6
92.5Florida
82.1
95.2New York City
81.8
92.9California
77.5
89.3Los Angeles
74.1
92.1San Diego
64.7
89.6Georgia
61.5
86.3Texas
60.0
82.0Texas
68.0
84.0**Table 2. Treatment Completion within 12 Months or Less among Newly Diagnosed TB Patients Age ≥15 who were Incarcerated at the Time of Diagnosis, United States, 2017**
States with 1 to 2 patientsStates with 3 to 4 patientsStates with 5 or more patientsStates with 1 to 2 TB patients age > 15 who were incarcerated
States with 1 to 2 TB patients age ≥ 15 who were incarcerated
Percentage of incarcerated patients age ≥ 15 who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Alaska
100.0
91.5Connecticut
100.0
98.0District of Columbia
100.0
76.7Indiana
100.0
96.4New Jersey
100.0
92.9New York
100.0
92.6Oklahoma
100.0
95.8West Virginia
100.0
84.6Arkansas
100.0
78.9Delaware
100.0
100.0Mississippi
100.0
86.4New Mexico
100.0
96.0Minnesota
50.0
95.7South Carolina
50.0
92.0Virginia
50.0
97.2Illinois
0.0
91.6Philadelphia
0.0
60.3States with 3 to 4 TB patients age > 15 who were incarcerated
States with 3 to 4 TB patients age ≥ 15 who were incarcerated
Percentage of incarcerated patients age ≥ 15 who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Los Angeles
100.0
92.1Massachusetts
100.0
94.6North Carolina
100.0
93.6Alabama
100.0
87.9New York City
100.0
92.9Colorado
66.7
91.2Louisiana
66.7
82.4Georgia
60.0
89.3**States with 5 or more TB patients age ≥ 15 who were incarcerated**
States with 5 or more TB patients age ≥ 15 who were incarcerated
Percentage of homeless patients age ≥ 15 who completed treatment within 12 months^
Percentage of all patients who completed treatment within 12 months†Tennessee
100.0
95.2Washington
100.0
93.4Arizona
94.4
92.5Houston
85.7
85.8Florida
83.3
95.2San Diego
80.0
89.6Georgia
71.4
86.3Missouri
66.7
73.6California
63.6
89.3Texas
46.8
82.0Footnotes**Figure 9.  Percentage of Newly Diagnosed TB Cases Completing Treatment ≤12 Months, United States, 2017**
The fraction in each parenthesis reports the number of TB patients who completed treatment within 12 months out of the total number of patients who were eligible to complete treatment within 12 months.
States/cities are grouped into thirds based on numbers of TB cases reported in 2017.
Baltimore, DC, DE, IA, ID, KS, ME, MT, ND, NE, NH, NM, RI, SD, UT, VT, WV, WI and WY reported 50 or fewer total TB cases in 2017. Due to the small denominator, data should be interpreted with caution.
*Data source: National Tuberculosis Surveillance System as of June 10, 2020*
**Table 1. Treatment Completion within 12 Months among Newly Diagnosed TB Patients****Age ≥15  who Experienced Homelessness within the Year Prior to Diagnosis, United States, 2017**
*States/cities are grouped into thirds based on numbers of homeless TB cases reported in 2017.
^Among those age >15 who were eligible to complete treatment within 12 months
†Among all patients of any age who were eligible to complete treatment within 12 months
Note: Baltimore, DE, IA, ID, KY, ME, MT, NE, ND, NM, OK, RI, SD, UT, VT, WV, WY did not report TB cases among persons age ≥15 experiencing homelessness who were eligible to complete treatment.
*Data source: National Tuberculosis Surveillance System as of June 10, 2020*
**Table 2. Treatment Completion within 12 Months or Less among Newly Diagnosed TB Patients****Age ≥15 who were Incarcerated at the Time of Diagnosis, United States, 2017**
*States/cities are grouped into thirds based on numbers of incarcerated TB cases reported in 2017.
^Among those age ≥15 who were eligible to complete treatment within 12 months
†Among all patients of any age who were eligible to complete treatment within 12 months
Note: Baltimore, Chicago, HI, IA, ID, KS, KY, MD, ME, MI, MT, ND, NE, NH, NV, OH, OR, PA, RI, San Francisco, SD, UT, VT, WI, WY did not report TB cases among incarcerated persons age ≥15 who were eligible to complete treatment.
*Data source: National Tuberculosis Surveillance System as of June 10, 2020*
							
					
						Page last reviewed:  November 2, 2020					Content source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeTuberculosisBasic TB Factsplus iconHow TB SpreadsLatent TB Infection and TB DiseaseSigns & SymptomsTB Risk FactorsExposure to TBTB PreventionVaccinesTB & HIV CoinfectionTB and DiabetesTB TermsPersonal StoriesTesting & Diagnosisplus iconWho Should be TestedTesting for TB InfectionTesting in BCG-Vaccinated PersonsTB Screening and Testing of Health Care PersonnelTesting During PregnancyDiagnosing latent TB infection and TB diseaseTreatmentplus iconDeciding When to Treat Latent TB InfectionTreatment Regimens for Latent TB Infection (LTBI)Treatment for TB DiseaseAdverse EventsTB Treatment of Persons Living with HIVTB Treatment and PregnancyTB Treatment for ChildrenFrequently Asked QuestionsDrug-Resistant TBResearchplus iconTB Epidemiologic Studies Consortiumplus iconResearch ProjectsPublicationsTB Trials Consortiumplus iconStudy DescriptionsBackgroundBehavioral & Social Science ResearchHealth Care Settingsplus iconTB Infection Control in Health Care SettingsResources for TB Screening and Testing of Health Care Personnelplus iconFrequently Asked QuestionsTB in Specific Populationsplus iconHealth DisparitiesAsian PersonsBlack or African American PersonsHispanic or Latino PersonsChildrenPregnancyCorrectional FacilitiesPeople Experiencing HomelessnessInternational TravelersLaboratory Informationplus iconDrug Susceptibility TestingFalse-Positive Investigation ToolkitInterim Laboratory Biosafety Guidance for XDR  tuberculosis strainsModel Performance Evaluation Program (MPEP)Rapid Molecular Testing to Detect Drug-Resistant TB in the USplus iconExecutive SummaryIntroductionBackground on Tests for Molecular Detection of DRGeneral Considerations and Principles for a Molecular DR Testing ServicePossible Scenarios and Scope of Testing for a Molecular DR Testing ServiceResearch NeedsGeneral Recommendations of the Expert PanelCommunication Plan for the ReportRecommendationsReferencesPanel Members and CDC ParticipantsAppendix 1Appendix 2Appendix 3The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TBplus iconGeneral ConsiderationsGeneral Recommendations of the Expert PanelRecommendations to ACET, CDC, DTBEData & Statisticsplus iconTB Incidence in the United StatesReported TB in the US, 2022 Surveillance Reportplus iconNational DataReporting Area DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBMolecular SurveillanceTuberculosis in the United States, 2022 (Slide Set)Archived Surveillance Reports and Slide Sets2021 State and City ReportArchived State and City ReportsProfessional Resources & Toolsplus iconTools for Healthcare ProvidersResources for TB Programsplus iconStrengthening Civil Surgeons’ Capacity to Improve LTBI Surveillance and Outcomes Among Status AdjustersNotice of Funding Opportunity (NOFO)Program EvaluationTB Centers of ExcellenceTB Elimination AllianceTB Genotypingplus iconConventional TB GenotypingWhole Genome SequencingTB GIMSAnalytic ToolsLatent Tuberculosis Infection ResourcesPublications & Productsplus iconPatient and Public MaterialsFact SheetsGuidelinesplus iconControl & EliminationDrug-Resistant TBInfection Control & PreventionLaboratory & GenotypingTB & HIVTB in Specific PopulationsTesting & DiagnosisTreatmentVaccines & ImmunizationsArchived TB GuidelinesGuides & Toolkitsplus iconAggregate ReportsCDC TB Surveillance TrainingCore CurriculumEffective TB Interviewing for Contact InvestigationEthnographic GuidesFalse-Positive Investigation ToolkitForging Partnerships to Eliminate TuberculosisGuide to Application of GenotypingLTBI: A Guide for Primary Health Care ProvidersMantoux Tuberculin Skin Testing ProductsReport of Verified Case of Tuberculosis (RVCT)Self-Study ModulesTB Contact Investigation Interviewing Skills CourseTB eDOT ToolkitUnderstanding the TB Cohort Review ProcessNewslettersplus iconTB Notes, No. 4, 2023TB Notes, No. 3, 2023TB Notes. No. 2, 2023TB Notes. No. 1, 2023TB Notes, No. 4, 2022TB Notes, No. 3, 2022TB Notes, No. 2, 2022TB Notes, No. 1, 2022TB Notes, No. 4, 2021TB Notes, No. 3, 2021TB Notes, No. 2, 2021TB Notes, No. 1, 2021Pamphlets, Brochures, Bookletsplus iconQuestions and AnswersPatient Education SeriesTuberculosis - Get the FactsTuberculosis - The Connection between TB and HIV12-Dose Regimen for Latent TB Infection-Patient Education BrochurePostersplus iconMantoux Tuberculin Skin Test Wall ChartWorld TB DayThink TBStop TBTake on TBReports & Articlesplus iconDTBE Authored Journal ArticlesTuberculosis Laboratory Aggregate ReportsSlide Setsplus iconIntroduction to TuberculosisEpidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016Self-Study Modules on Tuberculosis, 1-5 Slide SetsThe Tuberculosis (TB) in Correctional Settingsplus iconFacilitator GuideIntroduction to TB GenotypingEpidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017Prevention and Control of Tuberculosis in Correctional and Detention FacilitiesGuidelines for Preventing the Transmission of M. TB in Health care SettingsInvestigation of Contacts of Persons with Infectious TBEpidemiology of Pediatric Tuberculosis in the United StatesTargeted Tuberculosis Testing and Treatment of Latent Tuberculosis InfectionElectronic Tools & ResourcesWeb-Based Courses & Webinarsplus iconTB 101 for Health Care WorkersContent SyndicationInfographicsplus iconSocial Media GraphicsCustomizable Take on TB Infographic with InstructionsEventsWorld TB Dayplus iconU.S. TB ChampionsHistoryFeaturesplus iconTB Risk FactorsTreating Latent TB Infection with Short-Course RegimensWorld Tuberculosis (TB) Day 2021World Tuberculosis (TB) Day 2020Linksplus iconState TB Control OfficesAbout Usplus iconMission Statement and Activitiesplus iconDTBE Strategic PlanNational TB Program ObjectivesOrganization ChartAdvisory Groupsplus iconFederal TB Task Force To receive email updates about this page, enter your email address: Email Address			What's this?				Submit


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