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The Tuberculosis Epidemiologic Studies Consortium (TBESC) was created by the Division of Tuberculosis Elimination (DTBE) of the U.S. Centers for Disease Control and Prevention (CDC) in order to strengthen, focus, and coordinate tuberculosis research. The Hawai`i Department of Health is one of 22 sites in the United States and Canada that successfully competed for membership in the TBESC in 2001. Members of the TBESC are charged with designing, conducting, and evaluating programmatically relevant epidemiologic, behavioral, economic, laboratory, and operations research concerning the identification, diagnosis, prevention, and control of active TB disease and latent TB infection in North America. To read the abstract of the TBESC profile presented at the American Thoracic Society 2003 Conference, click here.

TBESC Sites

Current Research Projects

The TBESC provides a unique opportunity for Hawai`i to participate in a national consortium of academic, state and metropolitan TB sites contributing to progressive research that addresses current questions to improve the diagnosis and treatment of latent and active TB in North America. Many of the topics identified in the recent Institute of Medicine's (IOM) Report, Ending Neglect: The Elimination of Tuberculosis in the United States, are addressed by TBESC research projects to help accelerate the elimination of TB in the US and Canada. To read the CDC's response to the IOM report, click here.

The TB Control Branch of the Hawai`i Department of Health is currently involved in three TBESC research projects. Enhanced Surveillance to Identify Missed Opportunities for Prevention of Tuberculosis in the Foreign-Born, is the first large population-based epidemiological study of TB among the foreign-born in the United States and Canada. This cross-sectional study will focus on in-person interviews with a random sample of 1,500 cases - 50 of whom currently live in Hawai'i - who were diagnosed with TB in 2003-2004.

The second project, Factors Associated With Acceptance of, Adherence to, and Toxicity From Treatment for Latent Tuberculosis Infection, is a retrospective chart review intended to better understand the scope of treatment of latent tuberculosis infection (LTBI) in the United States and Canada, and to elucidate factors associated with acceptance and completion of such treatment. It will provide a description of the population being offered and given treatment for LTBI in the United States and Canada. A prospective cohort study of selected patients who have been offered treatment for LTBI will be conducted upon completion of the chart review. For further information regarding LTBI, click here.

The third project, Primary Care Management of Latent and Active Tuberculosis Among Immigrant Populations: a Study of Barriers and Facilitators, is intended to elicit and clarify the knowledge, attitudes, and practices of primary care providers who see foreign-born patients at risk for latent and active tuberculosis. Based on data provided during qualitative interviews, an intervention will be designed to improve provider knowledge, attitudes, and practice. Pre-and post intervention surveys will be conducted to document the impact of the intervention.

Given the high incidence of tuberculosis among Hawai`i's foreign-born population, local TB control activities need to be tailored to the special circumstances of the foreign-born. These circumstances often involve complicating factors such as visa status, drug resistance, social and economic hardships, linguistic barriers, and cultural beliefs that delay diagnosis and may interfere with adherence to therapy and cooperation with contact investigations. Our participation in TBESC research activities will enable Hawai`i to contribute to research leading to the development of interventions that can improve basic TB control activities and provide the scientific foundation for public health efforts to eliminate TB. For further information, you may contact the TBESC research department at the Hawai`i TB Control Branch.