Tuberculosis Elimination and Laboratory Cooperative Agreement - The proposed project reflects the New York City (NYC) Tuberculosis (TB) program's plans to continue to reduce morbidity and mortality caused by TB by 1) providing case management and TB treatment to all patients diagnosed with M. tuberculosis in NYC, 2) preventing persons from progressing from latent TB infection (LTBI) to TB disease, and 3) strengthening laboratory capacity to ensure timely and reliable laboratory services. The purpose of the funds received by the NYC TB program is to supplement state and local funds to prevent, control, and ultimately eliminate TB as a public health threat in NYC. Completing the proposed activities and achieving the desired outcomes described below is dependent upon receiving the funding reflected in the budget submitted with this application. Strategies and activities to be employed in the proposed work include: - Advise providers and laboratories to report suspected and confirmed cases in an accurate, timely, and complete manner - Diagnose and treat persons with TB disease through case management and provide directly observed therapy to support treatment adherence and completion; offer TB treatment and medications at Health Department TB clinics; collaborate with providers and other agencies to ensure that patients with newly-diagnosed TB complete treatment; provide consultation for treatment of multidrug resistant TB and other complicated cases; and use laboratory results for molecular detection of drug resistance to ensure patients are placed on appropriate treatment regimen - Identify and treat persons with LTBI through contact investigations for infectious TB cases, outbreak detection and investigation, evaluation of Class B immigrants and refugees, and targeted screening among other populations at high risk for TB - Conduct education, training, and outreach activities among healthcare providers, community-based organizations and the public - Conduct program planning, evaluation, and improvement to improve performance towards NYC TB program goals and national targets, inform policies and practices, including conducting cohort review process, and share best practices - Develop and implement human resource development plans to strengthen program capacity, including collaborations with community partners serving high-risk populations - Strengthen laboratory practices by ensuring availability of high-quality and prompt TB laboratory services Expected outcomes include: - Increased identification, evaluation, and treatment completion for individuals with TB - Increased capacity to adopt new technologies to support TB treatment, and increased capacity to diagnose and treat high-risk populations in a culturally-sensitive manner - Increased identification, evaluation, and treatment initiation/completion rates for individuals with LTBI, with emphasis on contacts, immigrants and refugees, and populations at high-risk of having LTBI or progressing to TB disease - Decreased turnaround times for testing and reporting of laboratory results. - Increased performance evaluation activities, identification and dissemination of best practices, and use of evaluation findings to inform policy