CDC's Response to Ending Neglect
GOAL VI: Track progress
Monitor progress toward the goal of TB elimination, and make
regular reports on progress to all target audiences.
Develop innovative analyses for examining surveillance data
to help focus elimination efforts.
Traditional analyses of surveillance data provide basic descriptive
epidemiology, including case counts and case rates by time, place,
and case characteristics. Since 1993, the expanded TB case report
has provided additional information on TB risk factors, such as
HIV status, initial drug resistance, and treatment. These additional
data elements have enhanced the ability at local, state, and national
levels to describe high-risk populations and assess program efforts
to ensure prompt and appropriate treatment for active cases. To
better focus elimination efforts, innovative analyses to supplement
traditional analyses will be needed. For example, the development
of a definition of elimination for areas where annual case counts
are very low (e.g., <10) and population size fairly small (e.g.,
<100,000) will help pinpoint regions on track for elimination.
- Convene CDC work group(s) to define areas where innovative
analyses would be most useful and to devise strategies for development
- Conduct and disseminate the results of innovative analyses
to better focus elimination efforts.
Develop novel indicators of progress toward elimination.
Traditional program indicators included annual incident case
counts and case rates, estimates of primary and acquired drug resistance,
and completion-of-therapy rates. Recently developed indicators of
successful contact investigations and targeted testing include completion-of-therapy
rates for persons identified with latent TB infection. As areas
progress toward elimination, further development of novel indicators
will be essential.
- Develop a CDC unit to work with partners from local, state,
and federal levels to periodically review standard indicators
and develop new indicators for use in measuring progress toward
- Develop meaningful and useful reports for program officials
and policy makers highlighting national progress using these standard
Conduct periodic evaluations of TB program performance at federal,
state, and local levels.
An important part of TB control efforts is continuous evaluation
of the effectiveness of control programs. Program evaluations provide
1) a feedback loop for data that can be used to refine operations
and procedures, 2) a rational basis for decisions about the relative
value of particular activities, and 3) information about ways to
improve specific aspects of a given program. Evaluations force persons
close to a program to step back and examine their efforts objectively.
This is especially useful for well-intentioned programs that may
be more concerned about addressing the immediate TB treatment and
control needs in their communities than in determining the best
ways to meet those needs. Methods to identify and correct problems
in TB control programs and systems must be developed before they
result in the further spread of TB disease and the development of
- Develop guidelines and standards for TB program evaluation.
Develop the capacity for program evaluation at the federal,
state, and local levels.
- Conduct research to identify best methods for the evaluation
of TB programs.
- Work with national organizations (e.g., ACET, NTCA, NCET)
to develop guidelines and standards for TB program evaluation.
- Disseminate guidelines and standards to state and local TB
- Incorporate evaluation as a core component of TB prevention
and control programs.
- Develop training in evaluation methods and techniques.
- Provide ongoing technical assistance in program evaluation.
- Develop information management systems to facilitate program
- Provide funding for program evaluation, utilizing the results
for strategic planning and program enhancement.
Conduct an annual progress review.
- Prepare annual progress reports for review by ACET and NTCA.
Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb
Please send comments/suggestions/requests
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333