CDC History of Tuberculosis Control - Medical and Public Health ...

More documents

Recommendations

Info

skin test. All 11 contacts with positive TST who were on the April flights and 2 of 3 contacts with positive TST on the Baltimoreto-Chicago flight in May had other risk factors for tuberculosis. More contacts on the 8.75 hour flight from Chicago to Honolulu had a positive TST than on the other three flights. Of 15 contacts with a positive TST on the Chicago-to-Honolulu flight, six (four with skin-test conversions) had no other risk factors; all six sat in the same section as the index patient. Passengers seated within two rows of the index patient were more likely to have a positive TST than those in the rest of the section. Transmission of M. tuberculosis in this setting involved a highly infectious passenger, a long flight, and close proximity of contacts to the index patient. The Division of TB Elimination and our partners in state and local health departments have benefitted tremendously from what has been learned from these and other outbreaks. Our continued cooperation, diligence, and timely systematic response to future outbreaks are critical to our eventual success in eliminating TB from the United States. International Activities by Nancy Binkin, MD, MPH, Chief, International Activity and Michael Iademarco, MD, MPH International Activity As the rate of tuberculosis (TB) cases falls in the United States (US), an increasing percentage of TB cases occur among US residents born in countries with a higher burden of TB. The US rate of TB cases is relatively low compared with the rate in 22 high-burden countries where 80% of global TB cases occur and where 62% of the world’s population resides. Given the latency period between TB infection and disease, continued immigration into the US, and increasing international travel, efforts to eliminate TB in the US must extend beyond our geographical borders. Recognition of the public health Notable Events in TB Control 65 impact of the global TB epidemic led CDC to officially organize an International Activity within the Division of TB Elimination (DTBE) in 1994 as international efforts are part of the overall strategic plan of DTBE. The mission of the International Activity is, first, to provide leadership and coordination for CDC activities related to improving TB prevention and control efforts among foreignborn persons in the US. Its mission is, second, to contribute to global TB prevention and control efforts by conducting operations research and providing technical support to high-priority countries, i.e., those that have a major TB burden or that are of strategic interest for TB control efforts in the US. Coordination and collaboration with other international public health partners are critical to accomplish our mission. Immigrants from Mexico, the Philippines, and Viet Nam are the leading contributors to the US foreign-born TB case burden and therefore constitute a high priority for TB control efforts in the US. The aim of International Activity efforts in these countries is to reduce the burden of TB by improving the TB control capacity of the respective national programs, by providing technical assistance and contributing to human resource development. Historically efforts in Mexico and the Philippines have been hampered by ongoing political and social changes. More recently, however, progress has been made. Mexico Because of their proximity and our shared border, persons born in Mexico represent the single largest group of foreign-born persons in
the US with TB. Previously CDC worked with the Mexican government to conduct surveillance of drug-resistant isolates of TB in Mexico as part of a WHO collaborative study. More recently, DTBE has been working with the United States Agency for International Development (USAID) and the National TB program of Mexico to identify areas of potential collaboration as part of a proposed 5year project to improve TB control. Proposed activities include expanding the number of directly observed treatment, short-course (DOTS) pilot projects, improving operations research capacities, and developing activities to foster public-private health sector collaboration. Additionally, DTBE has been a participating member of Ten Against TB, a binational initiative developed initially by the Texas Department of Health beginning in 1995. The ten US and Mexican border states have collaborated to reach a consensus on addressing joint issues of TB control through community-based public and private sector partnerships. Along with other partners in the Division and in the health departments of the border states, CDC has also been developing a series of recommendations to improve the diagnosis and management of cases along the US- Mexico border. Philippines In collaboration with the Department of Health of the Republic of the Philippines (DOH) and the Epidemiology Program Office of CDC, DTBE is providing technical assistance to a USAID-funded project. The objective of this 5-year project is to reduce the threat of HIV/AIDS and other selected infectious TB Control at the Millennium 66 diseases in the Philippines. Of those diseases in the Philippines, TB has the most significant public health impact and therefore figures prominently in the project. The broad, crosscutting nature of the project design addresses the decentralized health care organization in the Philippines. DTBE is working with the DOH to organize and conduct operations research training, expansion of directly observed treatment, short-course (DOTS) pilot projects, and public-private collaborative projects. Viet Nam Collaboration with the National TB Control Program of the Socialist Republic of Viet Nam (NTP) has been more longstanding. Since 1996, DTBE has worked with the NTP to improve TB control. Several laboratory quality control projects have been conducted and others are ongoing with the national reference laboratory responsible for southern Viet Nam. In 1997, DTBE conducted a 2-week operations research course for supervisory staff of the NTP and provincial TB managers held in Hanoi. As a result of the course, six protocols were developed on operational topics such as risk factors for treatment failure and for default, reasons for patient delay in seeking initial TB treatment, and knowledge, attitudes, and beliefs about HIV and HIV testing and counseling among TB patients. Each group has been provided with a CDC mentor and funding to conduct the research. The work for one protocol is complete and has been presented by the Viet Namese principal investigator at the International Union Against Tuberculosis and Lung Disease World Congress in Madrid this past September. Other projects are near completion. Based on the success of the operations research course and with support from USAID, DTBE has initiated a 3-year public health practice training program with the NTP. Botswana Other DTBE international efforts have aimed
Page 1 and 2:
Christmas Seal Campaign, 1945. Reco
Page 3 and 4:
A Century of Notable Events in TB C
Page 5 and 6:
was clearly evident in the literatu
Page 7 and 8:
grams that was emulated by other he
Page 9 and 10:
In 1947, the PHS organized and supp
Page 11 and 12:
and all patients were x-rayed annua
Page 13 and 14:
It was not until 1991 that TB got t
Page 15 and 16:
What is the role of New York City i
Page 17 and 18: Clinic (ECC) by directly observed t
Page 19 and 20: At first some of the nursing staff
Page 21 and 22: (NIH). Strong academic ties with th
Page 23 and 24: the greatest contribution of Nation
Page 25 and 26: on preventive therapy. In addition,
Page 27 and 28: changed to the American Trudeau Soc
Page 29 and 30: tic Standards and Classification of
Page 31 and 32: For several years many in the TB co
Page 33 and 34: through training. In 1993, the CDC
Page 35 and 36: New Jersey Medical School National
Page 37 and 38: Conferences specifically addressing
Page 39 and 40: Modeling the global fight against T
Page 41 and 42: (If annual incidence rates rather t
Page 43 and 44: 40 500 200 100 50 20 10 5 2 1 0.5 A
Page 45 and 46: Where We’ve Been and Where We’r
Page 47 and 48: working as a team with state and lo
Page 49 and 50: ended and outbreaks of MDR TB in ho
Page 51 and 52: patient care in light of these chan
Page 53 and 54: TB; and d) there was also a suggest
Page 55 and 56: appear to be more efficacious than
Page 57 and 58: therapy for pulmonary TB. Enrollmen
Page 59 and 60: ehavioral science and implementatio
Page 61 and 62: Division of Tuberculosis Control wi
Page 63 and 64: facilities to provide protection to
Page 65 and 66: issue recommendations, OSHA has the
Page 67: source patient, and one other patie
Page 71 and 72: DOTS-plus, the WHO strategy for the
Page 73 and 74: efugee is informed of the need to b
Page 75 and 76: the Soros Foundation, and the Rocke
Page 77 and 78: • The HIV/AIDS and TB epidemics c
Page 79 and 80: ology, diagnosis, treatment, preven
Page 81 and 82: the original designer of the poster
Page 83 and 84: TB Control at the Millennium 80
Page 85: TB Control at the Millennium 82
show all

CDC History of Tuberculosis Control - Medical and Public Health ...

Create successful ePaper yourself

Delete template?

Save as template?