Tuberculosis before and during COVID-19 Pandemic, United States, 2010-2023

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Tuberculosis (TB) incidence in the U.S. declined steadily from 2010 to 2019.
• A notable decrease in TB cases was observed in 2020, followed by increases in 2021-2023.

Purpose of the Study:

• To evaluate tuberculosis case counts and related metrics during 2020-2023 against pre-pandemic (2010-2019) projections.
• To assess the impact of the COVID-19 pandemic on tuberculosis surveillance data.

Main Methods:

• Utilized data from the Centers for Disease Control and Prevention's National TB Surveillance System and Electronic Disease Notification system.
• Employed Poisson regression models to predict expected TB case frequencies based on 2010-2019 trends.
• Compared observed 2020 data against predicted values for TB cases, diagnoses within 1 year of arrival, and class B TB recommendations.

Main Results:

• In 2020, observed TB cases (7,170) were lower than predicted (8,822).
• Fewer individuals received a TB diagnosis within one year of arrival (208 observed vs. 259 predicted).
• The number of individuals with class B TB recommendations was also lower than predicted (4,827 observed vs. 7,169 predicted).

Conclusions:

• The observed decrease in TB cases in 2020 suggests deviations from expected trends.
• Migration pattern shifts and COVID-19-related influences are probable contributors to the 2020 decrease and subsequent increases in TB cases.
• Further investigation is needed to fully understand the complex interplay of factors affecting TB epidemiology.