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Tuberculosis is still an important worldwide disease. There were an estimated 9.27 million incident cases globally of TB in 2007.1 This is an increase from 9.24 million cases in 2006, to 8.3 million cases in 2000 and 6.6 million cases in 1990. Most of the estimated number of cases in 2007 were in Asia (55%) and Africa (31%), with small proportions in the Eastern Mediterranean region (6%), the European region (5%) and the Americas (3%). The five countries that ranked first to fifth in terms of total numbers of cases in 2007 were India, China, Indonesia, Nigeria, and South Africa. Of the 9.27 million incident cases in 2007, an estimated 1.37 million (14%) were HIV positive; 79% of these HIV-positive cases were in the African region.

In 2008, a total of 12,898 incident tuberculosis (TB) cases were reported in the United States; the TB rate declined 3.8% from 2007 to 4.2 cases per 100,000 population, the lowest rate recorded since national reporting began in 1953. In 2008, the TB rate in foreign-born persons in the United States was 10 times higher than in US-born persons. TB rates among Hispanics and blacks were nearly eight times higher than among non-Hispanic whites, and rates among Asians were nearly 23 times higher than among non-Hispanic whites. To ensure that TB rates decline further in the United States, especially among foreign-born persons and minority populations, TB prevention and control capacity should be increased. Additional capacity should be used to (1) improve case management and contact investigations; (2) intensify outreach, testing, and treatment of high-risk and hard-to-reach populations; (3) enhance treatment and diagnostic tools; (4) increase scientific research to better understand TB transmission; and (5) continue collaboration with other nations to reduce TB globally.2

HIV-positive people are about 20 times more likely than HIV-negative people to develop TB in countries with a generalized HIV epidemic, and between 26 and 37 times more likely to develop TB in countries where HIV prevalence is lower.

The so-called atypical Mycobacteria (Mycobacteria other than Mycobacteria tuberculosis, or MOTT) cause skin disease more frequently than does M. tuberculosis. They exist in various reservoirs in the environment. Among these organisms are obligate and facultative pathogens as well as nonpathogens. In contrast to the obligate pathogens, the latter do not cause disease by person-to-person spread.

See reference 3. (eTable 184-0.1)

eTable 184-0.1 Classification of Mycobacteria

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