Epi Profile Section 3 - Affected Populations

Being born in and/or having extensively traveled to a high-incidence country is a major risk factor for contracting TB infection and TB disease in Texas. Persons born outside of the United States accounted for 61% of TB cases in Texas for 2019, compared to 71.4% of cases nationally.[1] Of the Texas TB cases born outside of the US, 39.3% were born in Mexico. Table 2 lists the top 15 countries of birth for 2019 TB cases in Texas. 

Table 2. Top 15 Countries of Birth for Non-US Born TB Cases in Texas, 2019

Tuberculosis case rates are higher along the Texas-Mexico border. Of the 12 border counties that reported TB cases in 2019, 11 had a TB case rate higher than the statewide case rate of 4.0 cases per 100,000. Given the frequent travel across international borders between counties along the Texas-Mexico border, local and regional health departments are faced with unique challenges relating to TB prevention and care. To address these challenges, the DSHS TB and Hansen’s Disease Branch Binational Programs provide services including case management, contact investigations, and TB infection treatment for individuals who have ties to the United States and Mexico. These four binational programs are in cities along the Texas-Mexico border, namely:

• Juntos in El Paso, Texas
• Los Dos Laredos in Laredo, Texas
• Grupo Sin Fronteras in Brownsville, Texas and McAllen, Texas
• Esperanza y Amistad in Del Rio, Texas and Eagle Pass, Texas

Map 2. Border County TB Case Rates per 100,000 Population, Texas, 2019

Table 3. TB Case Rates per 100,000 Population for Texas Border Counties, 2019

Table 4. Texas Border County TB Cases by Age, 2019

In 2019, 23.8% of cases diagnosed along the Texas border counties were under 25 years of age. Additionally, 5.2% of these cases were under 15 years of age, compared to 6.0% of cases in this age group in non-border counties for 2019. 

Child Morbidity

In Texas, the TB case rate for children aged 0-4 years old was 2.11 per 100,000 in 2019. Texas’ TB case rate is close to double the national rate for the same age group, which was 1.1 per 100,000.

In 2019, Texas accounted for 20% of all US TB cases diagnosed between ages 0-4 years old. In comparison, Texas reports 12.8% of US cases for all other age groups. Except for 2018, over the last five years, one-year old children are most commonly diagnosed with TB among children in the 0-4 age group in Texas. Furthermore, 92.9% of TB cases aged 0-4 years in Texas were born in the US and 83.3% did not report travel to a high incidence country. This is an indication of recent transmission from an adult TB case, due to their young age.
 

Figure 2. Child Morbidity from TB at 0-4 Years of Age, Texas, 2015-2019 

Data for Figure 2

Notes

1. Centers for Disease Control and Prevention (CDC). Reported Tuberculosis in the United States, 2019. Atlanta, GA: US Department of Health and Human Services, CDC; 2020.

Table of Contents | An Overview of Tuberculosis in Texas | Geographic Distribution of Tuberculosis in Texas | Affected Populations | Case Diagnosis | Recent Transmission | Mortality | Risk Factors Associated with Tuberculosis | Drug Resistant TB | Public Health Follow-Up Outcomes | Reporting Requirements | References