Tuberculosis
- Topics
- Basic TB Facts
- Treatment
- Testing & Diagnosis
- TB & HIV Coinfection
- Infection Control & Prevention
- Drug-Resistant TB
- TB in Specific Populations
- African-American Community
- Correctional Facilities
- Table of Contents
- Introduction
- Strengthen TB Information Systems and Program Assessment
- Strengthen TB Environmental Controls and Isolation Practices
- Provide More Comprehensive and Timely Screening and Diagnostic Evaluations
- Develop and Strengthen Contact Investigation Protocols
- Increase HIV Counseling and Testing
- Increase Staff Training
- Strengthen Collaboration Between Health Departments and Jails
- International Travelers
- Pregnancy
- Disaster Responders
- Children
- Vaccines & Immunizations
- Laboratory Information
- Drug Susceptibility Testing
- The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TB
- Rapid Molecular Testing to Detect Drug-Resistant TB in the US
- Executive Summary
- Introduction
- Background on Tests for Molecular Detection of DR
- General Considerations and Principles for a Molecular DR Testing Service�
- Possible Scenarios and Scope of Testing for a Molecular DR Testing Service
- Research Needs
- General Recommendations of the Expert Panel
- Communication Plan for the Report
- Recommendations
- References
- Panel Members and CDC Participants
- Appendix 1
- Appendix 2
- Appendix 3
- Interim Laboratory Biosafety Guidance for XDR Mycobacterium tuberculosis strains
- Molecular Detection of Drug Resistance (MDDR)
- Research
- TB Epidemiologic Studies Consortium
- Background
- Infrastructure
- Research Projects
- Publications
- Meetings
- Directory
- TBESC Committee Members
- Translating Research into Practice (TRIP)
- Contact TBESC
- Prospective Evaluation of Immunogenetic and Immunologic Markers for Susceptibility to Tuberculosis Infection and Progression from M. Tuberculosisinfection to active TB
- Zero Tolerance for Pediatric TB
- Models for Incorporating HIV Counseling, Testing, and Referral into Tuberculosis Contact Investigations
- Prevalence of Latent TB Infection Among High Risk Populations in the United States
- Regional Capacity-Building in Low-Incidence Areas
- Use of Network Analysis Methods to Characterize M. tuberculosis Transmission Patterns Among Women and Other High-Risk Populations
- An Analysis of Molecular Epidemiology of Multi-Drug Resistant M. tuberculosisin the United States
- Missed Opportunities for TB Prevention in Foreign-Born Population in the United States and Canada
- New Model for Assessing TB Surveillance and Action Performance and Cost
- Addressing TB Among African Americans in the Southeast: Identifying and Overcoming Barriers to Treatment Adherence for Latent TB Infection and TB Disease
- Assessing the TB Knowledge, Attitudes, Beliefs, and Practices Among Private Providers Serving Foreign-born Populations at Risk for TB
- Factors Associated with Acceptance of, Adherence to and Toxicity From Treatment for Latent TB Infection and Pilot Study of Treatment for Latent TB Infection Effectiveness
- Culturally Appropriate TB Educational Materials for Leaders and Staff of Hispanic Service Organizations
- Enhancing TB Programs� Capacity for Self-Evaluation: Testing New Tools and Developing an Evaluation Toolkit
- African Refugee Women�s Health Improvement Project
- Evaluation of the TK Medium: A New Rapid Solid Culture System for Tuberculosis
- Evaluation of New Interferon-y Release Assays in the Diagnosis of Latent TB Infection in Health Care Workers
- Request for Proposal
- TB Trials Consortium
- Behavioral & Social Science Research
- TB Epidemiologic Studies Consortium
- Data & Statistics
- Education & Training
- Resources for TB Programs
- Publications & Products
- Fact Sheets
- General
- Fact sheets - Spanish
- TB - General Information
- The Difference Between Latent TB Infection and Active TB Disease
- Diferencia entre la infección de tuberculosis latente y enfermedad de tuberculosis activa
- A Global Perspective on TB
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Bovine Tuberculosis in Humans
- Tuberculosis Information for International Travelers
- TB Can Be Treated
- Exposure to TB
- TB and HIV/AIDS
- You Can Prevent TB
- Testing for TB
- Tuberculosis: informaci�n general
- Diferencia entre la infecci�n de tuberculosis latente y enfermedad de tuberculosis activa
- Informaci�n sobre la tuberculosis para los viajeros internacionales
- Exposición a la tuberculosis
- Usted puede prevenir la tuberculosis
- La tuberculosis puede ser tratada
- Tuberculosis y VIH/SIDA
- Usted puede prevenir la tuberculosis
- Pruebas para detectar la tuberculosis
- Data & Statistics
- A Global Perspective on TB
- Trends in Tuberculosis – United States
- The Revised Report of Verified Case of Tuberculosis
- The National Tuberculosis Indicators Project (NTIP)
- National Tuberculosis Indicators Project (NTIP): Frequently Asked Questions
- TB Genotyping
- TB Genotyping Information Management System (TB GIMS)
- Drug-Resistant TB
- Multidrug-Resistant Tuberculosis (MDR TB)
- Extensively Drug-Resistant Tuberculosis (XDR TB)
- CDC’s Role in Preventing Extensively Drug-Resistant Tuberculosis (XDR TB)
- Tuberculosis multirresistente (MDR)
- Tuberculosis extremadamente resistente (XDR)
- El papel de los CDC en la prevenci�n de la tuberculosis extremadamente resistente (XDR)
- Infection Control & Prevention
- TB in Specific Populations
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Tuberculosis in Minorities
- Tuberculosis Information for International Travelers
- TB and HIV/AIDS
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tuberculosis in Blacks
- Tuberculosis and Pregnancy
- Tuberculosis y embarazo
- Treatment
- TB Can Be Treated
- Treatment of Latent TB Infection
- Treatment of Latent Tuberculosis Infection: Maximizing Adherence
- Treatment Options for Latent Tuberculosis Infection
- Treatment of Drug-Resistant Tuberculosis
- Treatment of Drug-Susceptible Tuberculosis Disease in Persons Not Infected with HIV
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tratamiento de la infecci�n de tuberculosis latente
- Testing & Diagnosis
- TB Can Be Treated
- Testing for TB
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Interferon-Gamma Release Assays (IGRAs)
- Tuberculin Skin Testing
- Diagnosis of Tuberculosis Disease
- Targeted Tuberculin Testing and Interpreting Tuberculin Skin Test Results
- Prueba cutánea de la tuberculina
- Diagnóstico de la tuberculosis activa
- Vaccines & Immunizations
- General
- Guidelines
- Guides & Toolkits
- Core Curriculum
- Self-Study Modules
- Report of Verified Case of Tuberculosis (RVCT)
- Forging Partnerships to Eliminate TB
- Understanding the TB Cohort Review Process
- Latent Tuberculosis Infection: A Guide for Primary Health Care Providers
- Effective TB Interviewing for Contact Investigation
- Mantoux Tuberculin Skin Testing Products
- Ethnographic Guides
- Newsletters
- Pamphlets, Brochures, Booklets
- Posters
- Mantoux Tuberculin Skin Test Wall Chart
- World TB Day
- Afiches
- 2011 Poster (English)
- 2011 Poster (Spanish)
- 2010 Poster (English)
- 2010 Poster (Spanish)
- 2008 Poster (English)
- 2008 Poster (Spanish)
- 2006 Poster (English)
- 2004 Poster (English)
- 2004 Poster (Spanish)
- 2003 Poster (English)
- 2003 Poster (Spanish)
- 2003 Now is the Time Poster (English)
- 2003 Now is the Time Poster (Spanish)
- Think TB
- Stop TB
- Reports & Articles
- Morbidity and Mortality Weekly Reports (MMWRs)
- Contact Investigations
- Control and Elimination
- Data & Statistics
- Drug-Resistant Tuberculosis
- Infection Control & Prevention
- Laboratory
- TB in Specific Populations
- Foreign-Born
- High-Risk Settings
- Homeless
- International
- Occupational Groups
- Travel
- TB & HIV
- Testing & Diagnosis
- Treatment
- LTBI Updates
- Vaccines & Immunizations
- World TB Day
- DTBE Authored Journal Articles
- Tuberculosis Laboratory Aggregate Reports
- Morbidity and Mortality Weekly Reports (MMWRs)
- Slide Sets
- Core Curriculum
- Self-Study Modules
- Prevention and Control of Tuberculosis in Correctional and Detention Facilities
- Guidelines for Preventing the Transmission of M. TB in Health care Settings
- Investigation of Contacts of Persons with Infectious TB
- Text-Only version
- Introduction
- Decisions to Initiate a Contact Investigation
- Investigating the Index Patient and Sites of Transmission
- Assigning Priorities to Contacts
- Diagnostic and Public Health Evaluation of Contacts
- Medical Treatment for Contacts with LTBI
- When to Expand a Contact Investigation
- Communicating Through the News Media
- Data Management and Evaluation of Contact Investigations
- Confidentiality and Consent in Contact Investigations
- Staff Training for Contact Investigations
- Contact Investigations in Special Circumstances
- Source-Case Investigations
- Cultural Competency and Social Network Analysis
- Resources
- Epidemiology of Pediatric Tuberculosis in the United States
- Text-Only version
- Introduction
- Pediatric TB Cases by Age and Race
- Pediatric TB Cases by Origin of Birth
- Pediatric Cases, Percentages and Rates by States
- Pediatric TB Cases by Case Verification Criterion and Site of Disease
- Pediatric TB Cases in Specific Groups
- Pediatric TB Cases Case Completion
- Slide 1
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- Slide 10
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Slide 15
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- Slide 20
- Slide 21
- Slide 22
- Slide 23
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Treatment of TB
- Targeted Tuberculosis Testing and Treatment of Latent Tuberculosis Infection
- CD Roms
- Electronic Tools & Resources
- Web-Based Courses & Webinars
- Fact Sheets
- Global TB
- Events
- Links
- About Us
- Mission Statement and Activities
- Organization Chart
- Advisory Groups
- Federal TB Task Force
- Table of Contents
- Executive Summary
- Introduction
- Chronology in the Development of This Report
- Strategies for Maintaining Control of TB
- Strategies for Accelerating the Decline of TB
- Activities for Developing New Tools
- Global U.S. Actions
- Assessing the Impact of Actions Taken
- Federal TB Task Force Members and Others Involved in the Development of This Report
- Glossary
- References
- Federal TB Task Force Roster
- Table of Contents
- Executive Summary
- Introduction
- How to Eliminate TB? – The IOM Report
- Why Eliminate TB? – Rationale for Elimination
- Who Will Lead? – CDC's Response
- Goal I: Maintain control of TB
- Goal II: Accelerate the decline
- Goal III: Create new tools
- Goal IV: Reduce the global burden of TB
- Goal V: Summon and sustain support
- Goal VI: Track progress
- References
- Federal TB Task Force
- Funding
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DTBE in South Africa
Capital City: Pretoria
Area*:1.2 million sq. km. (470,462 sq. mi.).
Population (est.), 2011*: 50.59 million
Estimated TB Incidence, 2010**: 981/100,000
Estimated TB Prevalence, 2010**: 795/100,000
Adult HIV Prevalence Rate, 2009***: 17.8%
Number of people living with HIV (PLHIV), 2009***:5,600,000
Percent of tested TB patients who were HIV+, 2010**: 60%
*Source: www.state.gov
**Source: WHO Global TB Control Report 2011
***Source: UNAIDS, Report on the Global AIDS Epidemic, 2010
Background
South Africa has the second highest rate of new tuberculosis (TB) cases in the world, the highest rate of drug-resistant TB in Africa, and the fourth highest prevalence of HIV/AIDS. Since 1996, when South Africa established a National TB Control Program (NTP) and adopted Directly Observed Therapy Short-course (DOTS) as its TB control strategy, the Centers for Disease Control and Prevention’s Division of Tuberculosis Elimination (CDC/DTBE) has provided technical assistance to the program. CDC/DTBE has worked with the South African Medical Research Council (SA MRC), the South African National Department of Health (SA NDOH) and provincial multidrug-resistant TB (MDR TB) treatment centers to address the challenges of MDR TB and co-infection with HIV and TB or MDR TB in South Africa. The U.S. and South African governments are focused on strengthening the NTP’s technical and information management capacity while improving service delivery. In 1995, the World Health Organization (WHO) accredited the SA MRC TB laboratory as the supranational reference laboratory for the region. South Africa continues to share their experience and knowledge about TB and HIV with other African countries.
Recent Accomplishments & Ongoing Collaborations
Program Strengthening and Epidemiology
Evaluation of the TB Surveillance System: CDC/DTBE and the SA MRC conducted a systematic evaluation of the TB Surveillance System and the Electronic Tuberculosis Register (ETR) in South Africa from 2011-2012. A standardized audit of patient-level information from multiple data sources from different levels of the public health system was used to assess the validity, reliability, efficiency, and utility of the TB surveillance system in South Africa. The study also included interviews with health care workers responsible for recording and reporting to determine knowledge and practices related to their duties. Analysis is underway to provide findings and recommendations to the TB program to strengthen their recording and reporting systems at all levels.
TB Tracer Project Evaluation: CDC/DTBE, the SA NDOH, and the SA MRC conducted an evaluation of the NDOH’s TB Tracer Project, which employed 72 tracer teams across the country to help identify patients who had defaulted from TB treatment and encourage them to return to therapy. The goal of this project was to reduce rates of default and improve TB treatment outcomes among TB patients. The evaluation concluded in early 2012 and analysis and dissemination of the findings are ongoing.
TB Infection Control Assessments and Training: The SA MRC and CDC/DTBE have partnered to conduct environmental infection control (IC) assessments and implement and evaluate infection control (IC) interventions in health facilities caring for TB patients. These assessments helped develop cost-benefit strategies for institutional infection control in hospitals in resource-limited countries where TB and MDR TB patients are treated. As part of the International Tuberculosis Research Center (ITRC), MRC and CDC/DTBE established joint faculty and developed a curriculum for training environmental specialists, clinicians, and health care workers on IC in public health facilities to identify IC risk areas and to develop cost-effective strategies. This curriculum has undergone continual improvement since its inception in 2006 and has been taught throughout the South African Development Community (SADC).
Multidrug-Resistant TB (MDR TB), TB/HIV, and Other At-Risk Populations
Epidemiology of Drug-Resistant TB (DR TB) among Children: Very little is known about the burden of DR TB in children. CDC/DTBE has been working with the SA MRC, NDOH, and the National Research Laboratory (NRL) to better understand this burden in South Africa. A study is underway to review all recording and reporting systems’ data in addition to medical records of children with DR TB to help describe the burden of disease, clinical and patient characteristics, and risk factors for poor treatment outcomes. In addition, the study aims to assess the ability of current national recording and reporting systems to capture data on children with DR TB. Data collection is ongoing in 2012.
TB and HIV Treatment Adherence: For patients with both HIV infection and TB disease, adherence to both treatment regimens can be difficult for many reasons. The level of adherence and the difficulties associated with non-adherence are not well understood in South Africa. CDC/DTBE and the SA MRC are collaborating to evaluate adherence to concurrent TB treatment and HIV Antiretroviral Treatment (ART) regimens in South Africa. In addition, HIV medical record systems will be evaluated to document flow of information and assess the knowledge and practices of those using the systems. Data collection was completed in early 2012, with analysis and dissemination of findings ongoing throughout 2012.
Preserving Effective TB Treatment Study (PETTS): In collaboration with the MOH and local partners in nine countries (including the Republic of South Africa), CDC/DTBE spearheaded the Preserving Effective TB Treatment Study (PETTS). PETTS, a large multi-year, multi-country study compared programs approved by the Green Light Committee (GLC) to programs that were not GLC approved; this was done to determine the incidence and consequences of acquired resistance to second-line drugs (SLD) among MDR TB patients. Preliminary results suggest that acquired resistance to these drugs was lower in GLC approved programs. GLC approved projects also demonstrated higher cure rates, lower mortality, and lower treatment failure rates when compared with non-GLC approved projects. PETTS has informed the new framework for WHO and international partners that support countries in achieving universal access to the diagnosis, treatment, and care of MDR TB.
MDR TB and HIV Partnership: The International Training and Research Center (ITRC) is a partnership between the government of South Africa and the U.S. Government. The purpose of the ITRC is to address MDR TB and the HIV epidemic. ITRC provides medical staff from several collaborating African countries to implement the treatment of MDR TB and HIV. Additionally, the ITRC equips public health professionals with scientific research, surveillance data, and knowledge to better control TB and HIV. The ITRC has developed curricula and conducts training for clinicians on the programmatic management of MDR TB and XDR TB. As of early 2012, more than 65 clinicians have been trained across nine provinces in South Africa.
Contact Us:
- Centers for Disease Control and Prevention
Division of Tuberculosis Elimination (DTBE)
1600 Clifton Rd., NE
MS E10
Atlanta, GA 30333 - 800-CDC-INFO
(800-232-4636)
TTY: (888) 232-6348 - New Hours of Operation
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Closed Holidays - cdcinfo@cdc.gov