The District of Columbia continues to experience a high burden of morbidity and mortality associated with tuberculosis (TB). The DC TB case rate of 5.2 per 100,000 is nearly double the national average. This burden in DC disproportionately affects vulnerable communities including those experiencing homelessness, individuals born outside the United States, and persons living with HIV.
The purpose of this project is to execute activities that will contribute to the prevention, control, and eventual elimination of tuberculosis in the District. Over the five-year project period, the District of Columbia Department of Health, HIV/AIDS, Hepatitis, STD and TB Administration, STD and TB Control Division proposes to reduce TB case rates in District residents as follows:
¿ Reduce TB in US-born persons to 0.4 per 100,000
¿ Reduce TB in foreign-born persons to 11.1 per 100,000
¿ Specifically, reduce TB in African-born population to 80 per 100,000
¿ Reduce TB in people experiencing homeless to 50 per 100,000
Program priorities include the diagnosis, management, and treatment of all reported cases of TB; evaluation and treatment, as appropriate, of persons found to be close contacts of persons with pulmonary TB; and, identification and treatment, as appropriate, of others at high risk for developing pulmonary TB. This will occur in conjunction with active consultation, training, educational activities and technical assistance to health care provider, correctional facilities and drug treatment programs, with the backbone to ensuring the availability of high-quality and prompt laboratory services.
Specific, measurable, achievable, realistic and time-based objectives have been developed to monitor programmatic progress and effectiveness. These objectives are consistent with Centers for Disease Control and Prevention (CDC) guidelines and best practices related to TB prevention and control and the CDC’s National TB Program Objectives and Performance Targets for 2020.
They include objectives related to case identification and ensuring completion of treatment of persons with TB infection and TB disease, TB surveillance, contact investigation, program evaluation initiatives, human resource development, and high quality laboratory services. The primary methods to be used to achieve the project objectives are comprehensive case management; field outreach for contact investigations; adherence promoting strategies (including in person and electronic directly observed therapy); application of current and evidence-based diagnostic and laboratory techniques; expansion of short-course regimens for treatment of TB infection, consultation with, and education of, medical and community partners; and, the collection, analysis and dissemination of data for use by program management, local public health officials, private providers and the CDC.