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TB Notes 3, 1999

Dear Colleague:

I hope this issue of TB Notes finds you in good health and enjoying the fall season. We had a very busy summer owing to the many projects we have taken on and to the meetings and conferences attended by staff of the Division of TB Elimination (DTBE). Among these meetings was the 30th IUATLD World Conference on Lung Health, held in Madrid, Spain, September 13-18. The Division was represented by over 30 poster and oral presentations at that conference. Staff also actively participated in this conference by sponsoring several special workshops, including postgraduate courses and a late-breaker session. At the request of the World Health Organization (WHO), CDC also sponsored an African regional meeting, as part of the ongoing "Stop TB" Initiative country consultations.

The applications for cooperative agreements for the year 2000 have all been received, allowing TB program staff to return to their regular TB prevention and control activities, while program consultants and other project officers busy themselves with reviewing the applications.

As we recently announced, next year’s National TB Controllers’ 2000 Workshop will be held August 30 through September 1, 2000, in Atlanta at the Omni Hotel, CNN Center. We are collaborating with Carol Pozsik, National TB Controller’s Association President (NTCA), and Walter Page, NTCA Executive Director, on the plans for next year’s meeting. To guide the planning process, we used the results of the NTCA survey on national meetings, and concluded that next year’s meeting will be kept separate from other organization meetings. Please hold these dates on your calendar, and ask the same of your nurse consultants and program managers who are likely to attend the 2000 Workshop next year. Current plans include conducting the separate and official NTCA annual membership meeting early on the afternoon of September 1; scheduling other special TB-related meetings (i.e., training, research, surveillance, etc.) on the morning of August 30; and conducting the DTBE Field Staff meeting on August 29. The planning committee will be working closely with Carol Pozsik and the NTCA in developing the details of the agenda. Further information will be provided as plans for this workshop continue to develop.

The 1998 U.S. tuberculosis statistics were published in an article in the Morbidity and Mortality Weekly Report (MMWR) of August 27, 1999, entitled "Progress toward the elimination of tuberculosis–United States, 1998." The citation for the article is MMWR 1999;48(33):732-736. In summary, 18,361 U.S. TB cases were reported for 1998, an 8% decline from the 19,851 cases reported in 1997, and a 31% decrease since 1993. We can all share in the credit for this overall 6-year decline. However, the national TB trends also point to a number of remaining challenges. Among these is the impact of the global TB epidemic on the United States. Also, while multidrug-resistant TB (MDR TB) cases have decreased, patient movement has resulted in MDR TB being reported from 45 states between 1993 and 1998. We must also improve the collection of information about HIV infection in TB patients. Matched TB and AIDS case registry studies suggest that at least 21% of persons aged 25 to 44 with TB also had HIV coinfection. Knowing the HIV status of TB patients is critical in order to accurately monitor the contribution of TB/HIV coinfection and provide the specialized clinical services essential to the care of these patients.

We now have the challenge of not only maintaining this downward trend, but of moving toward TB elimination as well. As I related in my last letter to you in TB Notes No. 2, 1999, CDC and the Advisory Council for the Elimination of Tuberculosis (ACET) have been working on a revision of the 1989 document, A Strategic Plan for the Elimination of Tuberculosis from the United States. This important document was published on August 13 as an article in the MMWR Recommendations and Reports series, entitled "Tuberculosis elimination revisited: obstacles, opportunities, and a renewed commitment." Advisory Council for the Elimination of Tuberculosis (ACET). MMWR 1999;48(No. RR-9).

This issue is shorter than usual because we are in the midst of planning and developing a special issue that we are calling TB Notes 2000, into which we are putting more effort and time than the regularly scheduled issues require. We expect to provide an overview of the history of the effect of TB on mankind; to describe the historical and current role of the DTBE; to offer articles on a wide array of TB control areas by experts outside CDC; and to provide order forms and samples of a variety of TB control education materials. Look for this special issue some time in January.

Kenneth G. Castro, MD


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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