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TB Notes 3, 2002

Updates from the Communications and Education Branch


The PARTNERS TB Control Program consists of a consortium of health organizations brought together by Harvard University, and funded by a grant from the Bill and Melinda Gates Foundation, with the purpose of addressing the problem of drug-resistant TB in Peru. In addition, the PARTNERS program seeks to create an exportable model for other countries to use in their MDRTB control programs. The program has four objectives:

  • Demonstrate the success of the project and take it to scale in Peru.
  • Define the necessary infrastructure and establish it in Peru to sustain a successful integrated program independent of PARTNERS.
  • Articulate the components of a replicable generic model drawing on lessons from Peru and Russia.
  • Provide strategies and a demonstration platform to strengthen global TB control efforts.

In addition to CDC, the following institutions participate in the PARTNERS program: the Peru Ministry of Health (MINSA) and Programa Nacional del Control de la Tuberculosis (PNCT), Socios en Salud (SES), Partners in Health (PIH), the Pan American Health Organization (PAHO) of the World Health Organization (WHO), the Tomsk TB Program in Russia, and the Task Force for Child Survival and Development.

The education, training, communication, and advocacy (ETCA) workgroup is one of five workgroups in the PARTNERS project. In March 2002, new representatives were appointed to the PARTNERS ETCA workgroup from the Ministry of Health in Peru (MINSA) and SES. Additionally, Dr. Eduardo Ticona was appointed in April 2002 to head the PNCT. The ETCA workgroup now has representatives from all PARTNERS members.

The PARTNERS project is in the middle of the second year of funding, and the ETCA workgroup assigned high priority to conducting a needs assessment in Peru to assist in identifying future workgroup activities. As representatives of the PARTNERS ETCA workgroup, Jacob Creswell and Nick DeLuca from DTBE’s Communications and Education Branch spent April 8-12 in Lima, Peru, conducting an assessment of Peru’s MDRTB training and education needs, and Jacob returned for a follow-up visit May 29-June 7. MINSA and SES work collaboratively to treat MDRTB patients within the PNCT of Peru.

The agenda for the trip included the following activities:

  • Meetings with staff from MINSA and SES.
  • Meetings with all five Lima Health District (DISA) coordinators and visits to different health centers within each DISA to talk to staff and to view health care facilities.
  • A total of 10 focus groups with MINSA and SES physicians, nurses, nurses’ aides, health promoters, and MDRTB patients.
  • Presentation of preliminary findings to MINSA and SES representatives.

The needs assessment focused on the following questions:

  • What are the overall MDRTB education, training, communication, and advocacy needs for health care workers (HCWs), patients, and the general public?
  • What current ETCA activities regarding MDRTB need to be strengthened?

Based on the needs assessment, the following general findings were identified:

(1) training for HCWs on MDRTB is limited; (2) MDRTB educational materials for HCWs are lacking; (3) the MDRTB training needs frequently identified included knowledge and management of adverse reactions to second-line drugs, management of comorbid conditions (e.g., MDRTB / HIV), infection control, HCW-patient communication, and patient emotional support; (4) there is a lack of educational MDRTB materials for patients and their families; (5) stigma is associated with MDRTB and affects both patients and HCWs; and (6) HCWs and patients expressed a desire to share common experiences regarding MDRTB.

The specific recommendations are based on the general findings and must be tailored to each group of HCWs (physicians, nurses, health promoters, DOT workers) and patients. The treatment guidelines for MDRTB should be clarified and expanded. MDRTB training courses and educational materials for HCWs must be created. Educational materials for MDRTB patients should be developed as soon as possible. After appropriate formative research has been conducted to determine the most effective methodology, campaigns should be implemented to combat stigma and discrimination associated with TB and MDRTB. A systematic process should be followed for the development of training, education, communication, and health promotion materials. Process and impact evaluation of all activities should be conducted. HCWs need channels for sharing their experiences and receiving updates on the management of MDRTB (e.g., grand rounds, regular meetings, written materials), and patients need forums for sharing their experiences. Finally, communication and collaboration between all PARTNERS members needs to be enhanced.

Some of the other priorities that came out of this assessment are the need to (1) contribute to the new national TB plan being created by MINSA; (2) create an inventory of existing and future TB and MDRTB educational and training materials in Peru in order to guide the development of materials; (3) develop an ETCA workgroup time line and plan based on the needs assessment and inventory; (4) maintain frequent communication among PARTNERS members; and (5) begin to develop patient materials based on the inventory and needs assessment findings.

Results of the needs assessment and future plans were presented at the PARTNERS meeting in Lima, Peru, July 19-20.

—Reported by Jacob Creswell, MPH
Division of TB Elimination

HIV/TB Info for AIDS Service Organizations


The Communications and Education Branch has developed a new brochure for AIDS service organizations (ASOs). The intent of the brochure is to motivate and enable ASO staff to seek or provide services for testing and treatment of latent TB infection (LTBI) among HIV-infected persons.

Finding and treating people with LTBI before they become sick — and infectious — is essential to eliminating TB in the United States. In fact, to speed the decline of TB in this country, the Institute of Medicine recommended that CDC increase testing and treatment for LTBI in high-risk groups. To that end, CDC, the American Lung Association, and the American Thoracic Society sponsored a partnership meeting for leaders of various organizations providing services for people at high risk for TB. Participants discussed what they needed in their efforts to provide such services. At the meeting, ASO attendees identified the need for educational materials about the importance of TB skin testing for persons with HIV infection.

Based on suggestions from the partnership meeting, a brochure was drafted and subsequently tested with a focus group which included physicians, health educators, and executive directors of ASOs. The brochure 1) incorporates specific language in the opening statement that captured the attention of ASO leaders, 2) uses instructional design that stimulated questions and reader desire to learn more, and 3) lists resources participants suggested as being the most valuable.

The next step in conducting formative research on the brochure was to obtain input on the document with state and big city TB controllers; this process was completed. The brochure was printed and has been distributed to TB control programs, and will be available for ordering mid-September at the DTBE Web site,

—Reported by Scott McCoy, MEd
Division of TB Elimination


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

Please send comments/suggestions/requests to:, or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333