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Border Report Section 6 – Tuberculosis

The rate of tuberculosis (TB) on the Texas-Mexico border has typically been higher than the rest of the state. Being born in a foreign country is a risk factor for TB and a large proportion of the population living on the Texas-Mexico border was born in Mexico or Central America. Higher than average rates of TB are also found in Houston and Dallas, where a large proportion of the population is also foreign-born.
 

Table 8a: Tuberculosis Diagnoses and Rate by EMA/TGA, 2017

Area

TB Diagnoses Number

TB Diagnoses Rate*

Texas

1,127

4.0

Austin TGA

49

2.3

Dallas EMA

213

4.3

Fort Worth TGA

88

3.6

Houston EMA

328

5.3

San Antonio TGA

78

3.4

East Texas TGA

51

1.9

All Other Texas

101

2.1

Texas-Mexico Border

219

7.9

* Rate per 100,000 population
Source: Texas TB Program Area Module as of 2017
 

Table 8b: Counties Where Tuberculosis Diagnosis Rate Exceeds the Texas-Mexico Border Region Average, 2017

County

TB Diagnoses Number

TB Diagnoses Rate*

Brooks

2

27.6

Cameron

52

12.3

Frio

12

61.2

Kinney

1

26.7

La Salle

1

13.2

Maverick

7

12.0

Reeves

3

19.6

Starr

9

14.0

Val Verde

11

22.4

Webb

25

9.1

Willacy

2

9.3

* Rate per 100,000 population
Source: Texas TB Program Area Module as of 2017
 

Rates of TB have been declining for both the state and the Texas-Mexico border region and are currently at their lowest levels since 1993 (Figure 6). However, rates in the border region remain twice as high as the state rate overall.
 

Figure 6. Tuberculosis Rates for the Texas-Mexico Border Region and Texas, 2008-2017
Figure 6. Tuberculosis Rates for the Texas-Mexico Border Region and Texas, 2008-2017
Source: Texas TB PAM as of 2017
Data for Figure 6
 

The demographics of persons diagnosed with TB on the Texas-Mexico border are similar to the state overall. Persons with TB in the Texas-Mexico border region tend to be less than 45 years old and are overwhelmingly Hispanic (93%), reflecting the demographics of the local general population. Diabetes, foreign birth, and incarceration are more common risk factors for persons with TB on the Texas-Mexico border, whereas homelessness is less common.
 

Table 9: Demographics of TB Cases Diagnosed in the Texas-Mexico Border Region and Texas, 2017

 

Texas-Mexico Border Region

Texas

Demographics

Count

Percent1

Rate*

Count

Percent1

Rate*

Total

219

100%

7.9

1,127

100%

4.0

Sex

 

 

 

 

 

 

Male

147

67%

10.7

734

65%

5.2

Female

72

33%

5.1

393

35%

2.8

Race

 

 

 

 

 

 

White

2

1%

0.8†

96

9%

0.8

Black

11

5%

30.9

213

19%

6.3

Hispanic

203

93%

8.3

593

53%

5.3

Other

3

1%

7.1

225

20%

11.9

Age Group

 

 

 

 

 

 

0-14

15

7%

2.1

57

5%

0.9

15-24

32

15%

7.1

109

10%

2.7

25-34

33

15%

8.7

173

15%

4.2

35-44

33

15%

9.5

197

17%

5.2

45-54

19

9%

6.1

179

16%

5.0

55-64

31

14%

11.9

186

17%

5.8

65+

56

26%

17.0

226

20%

6.5

Risk Factors^

 

 

 

 

 

 

Foreign Born

146

67%

-

689

61%

-

Alcohol Abuse

26

12%

-

130

12%

-

Diabetes

53

24%

-

213

19%

-

Correctional Facility

41

19%

-

94

8%

-

Homelessness

2

1%

-

40

4%

-

HIV Infection

11

5%

-

73

6%

-

* Rate per 100,000 people  
† Rates calculated with a numerator of ≤5 are statistically unstable and should be interpreted with caution
^ Risk factors are not mutually exclusive, TB cases can have multiple risk factors.
Source: Texas TB PAM as of 2017 
 

Certain tuberculosis outcomes for persons living in the Texas-Mexico border region were slightly worse than the state overall. While slightly fewer persons (5%) died prior to therapy completion in the border region compared to the state overall (6%)more of persons living in the border region died within a month of diagnosis (3%) compared to cases statewide (2%). Three percent of cases were lost to follow up in the border region compared to two percent statewide. About two percent of cases were diagnosed after death, indicating a missed opportunity for screening, detection, and treatment. Diagnoses after death may also indicate a missed opportunity to prevent transmission of TB infection to others.
 

Table 10: TB Outcomes for Cases Diagnosed in 2015

 

Texas-Mexico
Border Region

Texas

Case Outcome

Number

Percent

Number

Percent

Cases lost to follow-up

7

3%

24

2%

Cases that died prior to therapy completion

14

5%

76

6%

Deaths that occurred ≤30 days of diagnosis

7

3%

33

2%

Cases Diagnosed after Death 

6

2%

23

2%

Source: Texas TB PAM as of 2017
 

HIV, STDs, and TB in the Texas-Mexico Border Region