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No. 2, 2006
SURVEILLANCE, EPIDEMIOLOGY, AND OUTBREAK INVESTIGATIONS
BRANCH UPDATES
Enhanced Surveillance to Identify
Missed Opportunities for TB Prevention in the Foreign-born: Closing
the Gap
A CDC-funded study in the United States and Canada that is aimed at closing the gap in TB
incidence between native-born and foreign-born persons began in
April. Its purposes are to (1) describe the epidemiology of TB in
foreign-born persons in the United
States and Canada,
(2) identify missed opportunities to prevent development and transmission
of TB in foreign-born persons, and (3) make recommendations for
program improvements at the national, state or provincial, and local
levels. To date, study researchers have conducted almost 1,300 of
a planned 1,500 interviews with foreign-born persons newly diagnosed
with TB.
The study involves all 21 sites of the Tuberculosis Epidemiologic
Studies Consortium (TBESC) in 17 states and two Canadian provinces.
The TBESC was established in September 2001 to conduct TB research
and to strengthen TB public health infrastructure in the United States and Canada. The sites include academic institutions,
medical centers, and TB control programs. TBESC has 16 research
projects underway.
TBESC selected the epidemiology of TB in foreign-born persons as
a top research priority because of its critical importance to TB
elimination in the United States
and Canada. In the past decade, TB case numbers and
rates in North America have dropped faster
among native-born persons compared to foreign-born persons. The
result has been a growing gap in TB incidence between the two groups.
In 2003, the TB rate among foreign-born persons in the United
States (23.6 per 100,000) was almost nine times
higher than the rate among native-born persons (2.7 per 100,000);
foreign-born persons accounted for 53% of the 14,874 TB cases reported
in the United States.
This is the first large population-based epidemiologic study of
TB in foreign-born persons in the United States and Canada. To prepare for the study, TBESC researchers
developed and pilot-tested an hour-long questionnaire that asks
participants about their socioeconomic status, immigration and travel
history, history of TB symptoms and care sought for those symptoms,
previous treatment and testing for TB, and knowledge and attitudes
about TB. The questionnaire has been translated into 10 languages.
It will be supplemented with clinical data on each participant that
is routinely collected and reported to the CDC and Health Canada.
Researchers will enter the data into a Web-based data entry system
developed for the study that can also be adapted to other TBESC
studies.
Data collection will be completed in 2006. These data will be used
to identify interventions that can improve basic TB control activities
and inform public health efforts to eliminate TB in the United
States and Canada.
—Reported by Dolly Katz, PhD
Div of TB Elimination
Surveillance Team Update
The primary goal of the Surveillance Team is to maintain a
high-quality National Tuberculosis Surveillance System and to enhance
the dissemination and use of surveillance data in collaboration
with health departments. Following is an update on some of
the surveillance team’s current activities:
- OTIS, the Online Tuberculosis Information System, is now online
and available to the public. Users can request tabular counts
and percentages for 22 selected RVCT variables and rates for national
demographic data. The system can be accessed by going to
http://wonder.cdc.gov/tb.html or at
http://wonder.cdc.gov/,
then selecting Online Tuberculosis Information System.
- The National Surveillance System for Severe Adverse Events Associated
with Treatment of Latent TB Infection is underway. DTBE urges
health care providers and health departments to report all
severe adverse events (e.g., liver injury, metabolic acidosis,
anaphylaxis, seizure, severe dermatitis) leading to hospitalization
or death of a person receiving any treatment for LTBI that occurred
after January 1, 2004. Please report by telephone: 404-639-8401
or e-mail: LManangan@cdc.gov.
- In conjunction with World TB Day on March 24, 2006, DTBE
released an MMWR article on 2005 provisional surveillance
data. The annual report, Reported Tuberculosis in the
United States, 2005, with
final 2005 data, will be ready for distribution in December 2006. DTBE
is soliciting input on ways to enhance the dissemination and use
of the surveillance report. Please send your suggestions to GNewell@cdc.gov.
—Reported by Lilia Manangan and Glenda Newell
Div of TB Elimination
Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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