Understanding the TB Cohort Review Process: Instruction Guide
What Is the Cohort Review Method?
1. Program Objectives
Increased accountability helps TB control programs meet their program
objectives and national objectives. In order to assess progress
in attaining objectives, TB control teams must clearly delineate
the desired outcomes. Programs often have layers of objectives
that they are striving to meet simultaneously. At the national
level, the Centers for Disease Control and Prevention provides objectives
for all programs they support. State or local TB control programs
may also set objectives for program performance. The following
are examples of layered program objectives that can be monitored
with the use of cohort review.
Table 2: Examples of TB Program Objectives
CDC National Objectives*
- At least 90% of confirmed TB cases will complete treatment
within 365 days.
- At least 90% of sputum AFB-smear positive TB cases
will have contacts identified.
- At least 95% of contacts to sputum AFB-smear positive
TB cases will be evaluated.
- At least 85% of infected contacts started on treatment
for LTBI will complete treatment within 365 days.
of State Objectives
- At least 80% of TB cases will be treated by DOT.
- For close contacts placed on treatment for LTBI,
at least 90% of those persons under 15 and 75% of persons
15 and older will complete a recommended course of LTBI
of Local Objectives
- Health department staff will interview at least 90%
of persons with TB disease within 3 business days of
- At least 90% of contact investigations will be completed
within 90 days.
* “Department of Health and Human Services, CDC, Tuberculosis Elimination
and Laboratory Cooperative Agreements, Program Announcement Number
05003” (also referred to as the “FY 2005 TB Cooperative Agreement”).
“The benefit of cohort review, in my experience, is that you really
are changing the knowledge base of those who are practicing TB prevention
and control…in just a year, we had improved timeliness of contact
investigation and improved quality of our contact investigation.”
Kim Field, RN, MSN, TB Program Manager, Washington State Department
of Health TB Program