lunes, 2 de mayo de 2016

TB Notes Newsletter | TB Notes 2, 2016 | TB | CDC

TB Notes Newsletter | TB Notes 2, 2016 | TB | CDC

TB Notes 2, 2016April 28, 2016

Notes from the Director

Dear Colleague:
Last month, the Division of Tuberculosis Elimination (DTBE) released preliminary TB surveillance data 
for the United States. According to data from the CDC National TB Surveillance System, TB rates in the 
United States remained approximately 3.0 cases per 100,000 persons during 2013–2015. In 2015, a total 
of 9,563 TB cases were reported. This represents an increase of 157 cases from the 9,406 cases reported
in 2014.
Although we have seen two decades of declining incidence, progress toward TB elimination in the U.S. appears to have stalled. We know there has been much success in the early diagnosis, isolation, and treatment of those with infectious TB disease. However, to move the needle toward continued declines in TB incidence in the U.S., we must also focus on diagnosing persons with latent TB infection (LTBI) and treating them before they can progress to active TB disease.
The U.S. Preventive Services Task Force (USPSTF) supported this expanded approach toward TB elimination with its recent draft recommendation statement. The USPSTF issued a draft recommendation statement that calls for testing for adults who are at increased risk of having latent TB infection. The period for public comments on the statement was March 8th through April 4th.
DTBE has announced a funding opportunity to support these efforts. The project seeks feasible and scalable programs that expand LTBI testing and treatment to persons at high risk. The announcement was released on February 29th, but there is still time to apply. The closing date for applications is May 4th.
Philip LoBue, MD, FACP, FCCP
Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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Highlights from State and Local Programscollapse

Heartland National TB Center Offers Web-Series, Effects of Co-morbidities on TB Nurse Case Management
Heartland National TB Center (HNTC) is offering a five-part web series entitled Effects of Co-morbidities on TB Nurse Case Management. This series is intended for nurses and health care staff who care for persons diagnosed with TB and one or more co-morbidities.
The goal of this web series is to provide information from experts in the field of the identified co-morbidity which can affect TB treatment. Each session will also include a case study of a patient diagnosed with TB and an identified co-morbidity by a TB nurse expert to highlight considerations in case management.
Each session will provide 1.0 nursing continuation education contact hours.
Registration is FREE and required for each session; applicants will receive notification of their enrollment status via email. Additional details can be found on our website at
Catalina Navarro, RN, BSN and Debbie Onofre, RN, BSN are nurse consultants and educators at Heartland National TB Center with a combined total of 20 years’ experience in TB case management.
Part II: Substance AbuseApril 12, 2016 (Archived)
Dr. Heather Gotham is a licensed clinical psychologist and Associate Research Professor within the Collaborative for Excellence in Behavioral Health Research and Practice. She leads a Substance Abuse and Mental Health Services Administration (SAMHSA)-funded project to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use into nursing and social work programs.
Part III: Behavioral HealthMay 18, 2016 (Open)
Dr. Carolyn Harvey is currently the Assistant Professor of Community Health and Preventive Medicine at UT Health Northeast.  She is also the Program Manager for the Behavioral Health Integration Program where her primary role is to assist residents, primary care providers, and clinic staff in the management of mild to moderate behavioral health disorders within the ambulatory clinic setting.
Part IV: DiabetesNovember 14, 2016 (Open)
Dr. Adelita Cantu is an Associate Professor with the University of Texas Health Science Center San Antonio (UTHSCSA) and President of the American Diabetes Association Community (ADA) Leadership Board.
Part V: HIV/AIDSDecember 1, 2016 (Open)
Speaker to be announced, provided by the South Central AIDS Education and Training Center (SCAETC).
Submitted by Jessica Quintero, M.Ed., Heartland National TB Center

Corrections Liaison Partnership Committee
CDC has recommended that a corrections liaison be appointed by the State TB program for each state and territory in the U.S.  The National TB Controllers Association (NTCA) Corrections Liaison Partnership Committee is a resource for states and correctional liaisons. This group maintains aList of Corrections Liaisons by State.  The list was last published in July 2015 and is currently under revision. 
Additionally, the liaisons hold quarterly calls to discuss working through the Public Health Corrections Liaison Competencies and identifying how they work with TB programs, correctional facilities, and the corrections culture. Items covered in these calls include case scenarios, how to work with inmates, and challenges with medical and custody staff.  Callers have the opportunity to ask questions and identify training opportunities within each state and at national conferences.  The group has discussed tips for speaking at sheriff and jail conferences and how to use case scenarios to tailor training to specific audiences.  They meet quarterly and keep the National Corrections Committee apprised of the workgroup’s initiatives.  If you are a correctional liaison and would like to be added to the liaison list and/or the quarterly calls, please contact Ellen Murray.
Submitted by Ellen Murray, BSN, RN, Southeastern National Tuberculosis Center

NTCA Corrections Workgroup Activities
For those searching for TB materials to use in correctional settings, the NTCA Corrections Education and Training Workgroup developed a new repository of materials, called CorrectTB. The team is looking for additional materials to add to the site.  If you have tools or educational materials that you find useful in a correctional setting, please send them to the Corrections Committee at  with the subject line “CorrectTB Resource(s).”
Submitted by Ann Sittig, RN, PHN, MPH, Minnesota Department of Health and Molly Dowling, MPH, CHES, DTBE

3HP Explored in a National Webinar
On March 17, 2016, the Curry International Tuberculosis Center (CITC) hosted a national webinar titled, INH and Rifapentine Treatment for LTBI: Expert Opinions About 3HP Utilization. The 90-minute event featured a panel of experts discussing key issues faced by healthcare providers when using 3 months of isoniazid and rifapentine once weekly (3HP) to treat latent TB infection (LTBI). 
The topic of the 3HP treatment protocol is closely aligned with the national TB elimination strategy of reducing TB cases by addressing the reservoir of LTBI.  Training needs assessments conducted by CITC have long indicated a strong interest among health providers for more information about the 3HP regimen. Nevertheless, when CITC staff opened registration for the webinar, they were astonished by the overwhelming response; there were over 900 registrants within the first 2 weeks.
The live webinar featured Heidi Behm, RN, MPH, TB Controller for the Oregon Health Authority, who facilitated an expert panel comprised of:Marcos Burgos, MD, New Mexico Department of Health; Neha Shah, MD, MPH, CDC/California Department of Public Health; and Mai Vu, PharmD, San Francisco VA Medical Center.  
After Dr. Shah provided an overview of findings from clinical studies related to 3HP, the panel directly explored an array of questions often posed by providers who are using (or considering) the 3HP regimen for their patients:  How should missed doses be handled?; What are the most common drug-drug interactions?; How can side effects be minimized?;  How does 3HP compare with other LTBI regimens in terms of hepatotoxicity?; How does 3HP work for special patient populations such as those who are elderly, diabetic, HIV-positive, methadone users, coumadin users, and patients on dialysis?
During the webinar, participants commented about the U.S. Preventive Services Task Force Draft Recommendation Statement on LTBI Screeningthat will recommend testing for LTBI in at-risk adults. This recommendation could pave the way for insurance coverage of TB testing.  
According to data gleaned from 411 participant evaluation responses, three-fourths of attendees (77%) were nurses who work for TB control/public health programs. The webinar was highly-rated by participants (average 8.94 of a maximum of 10), who participated from all 50 states.  Many attendees indicated the webinar content validated their current experience with 3HP; others commented that the webinar left them better-equipped to initiate a 3HP program in their facilities.  As one participant noted, “We are in the process of implementing 3HP in our ambulatory care setting, so this was very helpful in terms of ideas for protocols, monitoring, etc.”
The INH and Rifapentine Treatment for LTBI: Expert Opinions About 3HP Utilization webinar is archived on the CITC website and available for viewing.
Submitted by Kelly Musoke, MPH, Curry International Tuberculosis Center

Office of the Director Updatesexpand

Communications, Education, and Behavioral Studies Branch Updatesexpand

Data Management, Statistics, and Evaluation Branch (proposed) Updatesexpand

Laboratory Branch Updatesexpand

New CDC Publicationsexpand

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