TB Notes 4, 2019 | Newsletters | Publications & Products | TB | CDC

TB Notes 4, 2019 | Newsletters | Publications & Products | TB | CDC

Improving screening, testing, and treatment for Latent TB Infection (LTBI): Closing the Gaps in the TB Prevention Cascade in Community Health Clinics (CHCs)

More than two-thirds of tuberculosis (TB) cases diagnosed in the United States are among non-U.S.–born persons, and more than 90% of these TB cases are due to reactivation of latent TB infection (LTBI) most likely acquired in their countries of origin. Improved screening, testing, and curative treatment of LTBI among high-risk populations is a critical component of the U.S. TB elimination strategy.

The Tuberculosis Epidemiologic Studies Consortium (TBESC) is a partnership of the Division of Tuberculosis Elimination (DTBE), Centers for Disease Control and Prevention (CDC) with academic institutions and TB control programs in 11 states; its current focus is LTBI prevention, identification, and treatment. To help meet CDC’s TB elimination goals, TBESC initiated a study to identify barriers to LTBI diagnosis and treatment at community health clinics (CHCs), and to inform interventions to overcome them. CHCs are important partners for TB prevention and control; they promote community engagement and reach high-risk communities in medically underserved areas. The study, “Improving screening, testing, and treatment for Latent TB Infection (LTBI): Closing the Gaps in the TB Prevention Cascade in Community Health Clinics,” began data collection in November 2019.

The study will use a mixed methods approach to quantify current levels of LTBI testing and treatment in CHCs and investigate barriers to scale-up of these activities. Consortium members recruited 16 CHCs that serve non-U.S.—born populations, primarily Asian and Hispanic communities. Most clinics serve as safety net clinics for under- and uninsured individuals. Patient chart abstractions will help identify gaps in the LTBI Care Cascade. Provider surveys and in-depth interviews with clinic leadership, providers, and support staff will identify barriers and facilitators for screening, testing, and treatment. The results of this study will help guide the development and implementation of future CHC-based interventions to address LTBI in at-risk communities.

Submitted by Katharine Tatum