Connecticut Tuberculosis Elimination and Laboratory Cooperative Agreement 2025-2029 - Until the COVID-19 pandemic, the U.S. and Connecticut (CT) had seen declining rates in tuberculosis (TB) disease since 1992. In the first years of the pandemic, TB case rates declined substantially, only to bounce back during 2022–2023. In the U.S., TB is on the rise with 9,615 TB cases reported in 2023, compared to 8,320 cases in 2022. CT is seeing comparable increases with preliminary TB disease data for FY2024 showing a trend towards the highest case count since 2012 (74 cases). In addition to increasing case counts, CT’s TB cases continue to be both socially and medically complex. During 2022–2023, CT saw 308 persons diagnosed with TB disease, nine of which were multidrug-resistant. Among these 308 persons, 1.3% of these were children ≤5 years old, and 24.6% in persons ≥65 years old, with a median age of 42.5 years. Sixteen percent had diabetes, and 4% were coinfected with HIV. Nineteen percent of persons diagnosed with TB reported substance abuse risk factors. CT’s risk population for TB is primarily non-U.S. born persons that live in or visit the state. From 2019– 2023, most persons diagnosed with TB disease were non-U.S. born (86% average). All of these characteristics present their own challenges in addition to TB disease. As a low-incidence jurisdiction and given the rapidly changes in rates of TB disease in CT, attention must shift to populations at high risk for TB disease in CT. The purpose of this application is to receive funds to enable the CT TB Control Program (CTBCP) to maintain or improve current TB activities. TB elimination in CT will focus on the following priority strategies: a) identification and full treatment of persons with TB disease, as well as those prioritized as high risk for LTBI and progression to disease (e.g., contacts to TB cases, pediatric patients, and non-U.S. born persons), b) modernization of database systems and reporting structures to strengthen TB/LTBI surveillance, c) evaluation, education, and training activities to address changes in both the health care workforce and new clinical guidelines and regimens, and d) state laboratory practices and procedures to ensure timely and reliable results for detecting and reporting TB. Also included are strong and expanded collaborations, education/training of partners, strengthening surveillance capacity with new/updated databases, and learning from evaluation plans. Finally, a new CT TB Elimination Plan, a new TB Drug Shortage Contingency Plan, and new Evaluation and Performance Measurement Plan (EPMP) activities will further formalize the CTBCP’s strategies and activities to eliminate TB in CT.