Reported Tuberculosis in the United States, 2020

Successful completion of TB treatment for persons with TB disease is a major performance indicator for TB programs.

Data collected by date and reason therapy was stopped (e.g., the patient completed therapy or the patient died) were used to calculate completion of therapy percentages. Cases of TB disease were stratified by the indicated length of therapy, based on American Thoracic Society, CDC, and Infectious Diseases Society of America treatment guidelines in effect during the period covered, the patient’s initial drug-susceptibility test results, age, and disease site.

Effective TB treatment for TB disease includes providing multiple anti-TB drugs given over a sufficient period of time to prevent development of drug resistance, minimize the risk of transmission to others, and ultimately, cure the patient of TB disease.

The most common initial treatment regimen for drug-susceptible TB disease, and in situations where drug-susceptibility is unknown, includes isoniazid, H; rifampin, R; pyrazinamide, Z; and ethambutol, E (HRZE).

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Among persons alive at diagnosis with initial drug regimen information available in 2020,

• 83.3% began treatment with HRZE,
• 10.7% began treatment with a four-drug regimen other than HRZE, and
• 6.0% were not on a four-drug regimen.

Source: Treatment and Outcomes Among TB Cases: 1993–2020

Successful completion of TB therapy for TB disease is important to prevent recurrence of TB disease and drug resistance.

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• The national goal for treatment completion is that, for patients with newly diagnosed TB disease for whom ≤12 months of treatment is indicated, 95% complete treatment within 12 months.
• Although the percentage of eligible patients completing therapy in 1 year has risen since 1993 from 63.4% to 89.1% in 2018, the nation is still short of the 95% goal, and the percentage has been relatively level since 2009.

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In 2018, the most recent year for which complete data are available, among persons with TB disease, 801 (8.9%) died (Deaths Among TB Cases: 2010–2018).

• There were 197 patients who were dead at the time of TB diagnosis and 604 patients who died during treatment.
• Out of the 8.9% who died, slightly more than 35% were attributed to TB disease.
• The percentage who died among persons with TB disease has remained consistent with previous years.

Learn more in the Executive Commentary.