About
TB Notes is a quarterly newsletter from the Division of Tuberculosis Elimination, featuring director's notes, updates from branches, activity overviews, and recent publications to keep you informed on CDC's tuberculosis prevention efforts and advancements.
Notes from the Director
Dear Colleagues,
We hope this second edition of the TB Notes newsletter for 2024 finds you well. I am pleased to provide a few select updates on the Division of Tuberculosis Elimination (DTBE) activities. DTBE welcomed TB educators, program evaluators, TB program staff, and other partners to Atlanta for the TB Education and Training Network (TB ETN) and Program Evaluation Network (PEN) Conference, held September 17-19. The last TB ETN/PEN conference was held in 2018, over six years ago. There were many new conference participants. The conference featured engaging plenary sessions, thought-provoking discussions, and invaluable networking opportunities.
In addition to the TB ETN and PEN Conference, the TB Epidemiologic Studies Consortium-III (TBESC-III) met in Atlanta September 23-24. TBESC-III is evaluating interventions to increase treatment of latent TB infection in primary care settings. Participants shared research findings and discussed ongoing studies. The TB Trials Consortium (TBTC) will meet virtually later this month.
Finally, DTBE is pleased to announce that we will be continuing our work with the TB Elimination Alliance partners (TEA) (Association of Asian Pacific Community Health Organizations, the Asian Pacific Islander American Health Forum, Stop TB USA, and Hep B United) through the next cycle of the National Partners Cooperative Agreement.
These are just a few highlights from our work over the past quarter. I invite you to read further for additional news and resources from across DTBE.
Thank you for your continued efforts toward our goal of TB elimination.
Philip LoBue, MD, FACP, FCCP
Director
Division of Tuberculosis Elimination
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Office of the Director
Policy Toolkit for Improving Access to Critical Medicines
The Association of State and Territorial Health Officials worked with the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, including the Division of STD Prevention, and DTBE to develop a drug shortages policy toolkit. This toolkit summarizes policy levers and strategies health agencies and public health programs can use to improve access to critical medicines, particularly drugs used to treat TB and syphilis. Experts in the field informed the toolkit, which includes case examples and resources to support contingency planning for drug shortages and other medication access challenges.
Submitted by Susan McClure, MPH, Associate Director for Policy and Issues Management
Clinical Research Branch
Tuberculosis Trials Consortium Meeting
The Clinical Research Branch (CRB) of DTBE is looking forward to its next Tuberculosis Trials Consortium (TBTC) meeting, scheduled virtually from October 22 to 24. This meeting will focus on study updates and planning for their three major trials: CRUSH-TB (Combination Regimens for Shortening Tuberculosis Treatment)/Study 38; ASTERoidD (Assessment of the Safety, Tolerability, and Effectiveness of Rifapentine Given Daily for Latent TB Infection)/TBTC Study 37; and TBTC Study 35, CRB's trial for appropriate dosing of a novel water-dispersible, child-friendly formulation of rifapentine with isoniazid in children aged 0-12 years.
TBTC will also recruit and vote on new members and chairs for the TBTC's active committees. The committees that shape TBTC include the Core Science Group, which develops the scientific program of research; the Implementation and Quality Committee, which supervises the conduct and quality of ongoing studies; the Publications and Presentations Committee, which ensures quality and equity in TBTC's reporting; and the Advocacy and External Relations Committee, which represents the TBTC to outside entities and supports the Consortium's community engagement activities.
Submitted by Carla Jeffries, JD, MPH, Deputy Chief, Clinical Research Branch
Communication, Education, and Behavioral Studies Branch
TB Elimination Alliance (TEA) Updates
TEA will continue activities through the next cycle of the National Partners Cooperative Agreement. TEA has recently published an Impact Report and Evaluation Report with highlights and information on their activities from the previous cycle. To learn more about TEA, visit the TEA website.
Submitted by Leeanna Allen, MPH, Communications Team Lead
2024 TB ETN and TB PEN Conference: Advancing TB Education, Training, and Program Evaluation
The Tuberculosis Education and Training Network (TB ETN) and the Tuberculosis Program Evaluation Network (TB PEN) Conference took place September 17-19, 2024, in Decatur, Georgia. Since 2010, TB ETN and TB PEN have worked in collaboration to plan, implement, and evaluate the joint biennial TB ETN and TB PEN Conference. The last conference was held in 2018, partly due to the COVID-19 pandemic, but returned in 2024 after a 6-year hiatus. The conference provided an opportunity for TB program staff to enhance their knowledge of TB education, training, and program evaluation and attracted over 180 participants from TB programs across the United States.
Attendees participated in a wide range of activities throughout the conference, including skills-based workshops, informative presentations, round table discussions with subject matter experts, and networking opportunities. Faculty included CDC experts from the Division of TB Elimination, the Division of Workforce Development, the Division of Global Migration and Health, and the Division of Global Health Protection, as well as several other experts from outside of CDC.
Conference breakout and plenary sessions explored subjects including the impact of artificial intelligence on public health education and communication, improving identification and treatment of high-risk populations through training, risk communication strategies, cultural considerations in newcomer communities' TB programs, as well as strategies for enhancing contact investigation examination and treatment initiation. TB survivors from We Are TB, added a powerful dimension to the conference by sharing their personal stories, insights, and the importance of advocating for and supporting those affected by the disease.
The conference also dedicated sessions to important initiatives such as the Tuberculosis Centers of Excellence for Training, Education, and Medical Consultation activities. Additionally, there were sessions on human resources development updates for TB education, training, and evaluation focal points, program evaluation survey design, and data analysis. Plenaries on health equity and TB and the DTBE supported Think. Test. Treat TB campaign and the TB Elimination Alliance provided valuable forums for thoughtful conversations on these critical topics.
A scientific poster session showcased 24 abstracts from various U.S states and affiliated territories. Four abstracts were selected for oral presentations.
The conference provided an excellent opportunity for TB program staff to expand their understanding of TB education, training, and program evaluation. Participants left the conference with new knowledge and skills to apply back in their TB programs.
Submitted by The TB ETN-PEN Planning Team
Data Management, Statistics, and Evaluation Branch
Dr. Andrew Hill Selected as Chief of the Data Management, Statistics, and Evaluation Branch
DMSEB is pleased to announce the selection of Andrew Hill, Ph.D., as Chief of the Data Management, Statistics, and Evaluation Branch (DMSEB), Division of Tuberculosis Elimination (DTBE). He officially assumed this role on August 25, 2024.
Andrew came to CDC in 2007 as a contractor in the Division of Bacterial Diseases (DBD). In 2008, he joined DTBE's Data Management and Statistics Branch, eventually becoming a Team Lead. He developed the first mathematical model to project U.S. TB trends during this time. In 2014, he served as the statistical and modeling SME for TB research under the NCHHSTP Epidemiologic and Economic Modeling Agreement (NEEMA).
In 2022, he moved to the Division of Parasitic Diseases and Malaria, where he consulted on multiple projects. This included the Nigeria Multi-Disease Serologic Surveillance study (NMS4) and the impact of insecticide-treated nets on mosquitoes in Colombia. He also led efforts to identify U.S. jurisdictions at high risk for malaria following the domestic outbreak in 2023.
Andrew earned his bachelor's and master's degrees in mathematics and physics from the University of Auckland and a doctorate in mathematics from the University of Canterbury, New Zealand. He holds an Adjunct Professorship at Emory University. Andrew has published on mathematical modeling applied to diseases such as pertussis, Ebola, and measles. His work also includes a co-authored model on the effectiveness of face masks during the COVID-19 pandemic.
Laboratory Branch
Laboratory Branch Personnel Announcements
The Laboratory Branch is pleased to announce new personnel.
Noah Burg, PhD, Associate Service Fellow
Noah began his CDC career by completing the CDC's Laboratory Leadership Service (LLS) Fellowship in the STD Laboratory Reference and Research Branch (SLRRB) within NCHHSTP's Division of STD Prevention.
As an LLS fellow, Noah focused on a research project using genomic data from national gonorrhea surveillance efforts. He supported laboratory operations and was the point of contact for all laboratory tours. He also gained experience with response work through the fellowship. Beyond his work in SLRRB, Noah is a docent at the CDC Museum.
Noah earned his PhD in biology at City University of New York. He conducted his doctoral research at the Institute for Comparative Genomics within the American Museum of Natural History in New York City.
Verden Douglas, MS, MBA, Laboratory Quality Management Specialist
Verden brings a strong background in CLIA, GLP, and QMS. He also holds ASQ Quality Auditor certification and Lean Six Sigma Black Belt certification.
Verden earned a Bachelor of Science in Biology and a Master of Business Administration from Mount Olive College in Mount Olive, North Carolina. He also holds a Master of Science in Quality System Management from New England College of Business in Boston, Massachusetts.
Aimee Tierney, PhD., ORISE Fellow
Aimee began her CDC career in 2022 as an ORISE Fellow in the Enteric Diseases Laboratory Branch within NCEZID. During her fellowship, she conducted bioinformatics research on Salmonella virulence genes. She will develop and validate bioinformatics workflows for tuberculosis outbreaks and drug resistance detection in her new role.
Aimee earned her bachelor's degree in biology from Oglethorpe University in Atlanta, GA, and her PhD in microbiology and molecular genetics from Emory University.
Submitted by Monica E. Youngblood, MPH, M(ASCP) Microbiologist/TB Laboratory Consultant
Surveillance, Epidemiology, & Outbreak Investigations Branch
Public Release of Tuberculosis Epidemiologic Studies Consortium (TBESC)-II Part A Data
CDC has released a public data set, including a data dictionary and data use guide, for TBESC-II Part A data. This study was a head-to-head comparison of three Food and Drug Administration (FDA)-approved tests for tuberculosis (TB) infection (Tuberculin Skin Test, QuantiFERON-TB Gold In-Tube, and T-SPOT.TB) in populations at high risk of latent TB infection and/or progression to TB disease. The dataset contains test results, treatment and imaging data, demographics, and risk factors for 22,020 participants enrolled between 2012 and 2020. Researchers followed participants for two years after enrollment to monitor possible progression to TB disease and analyzed the three tests for their ability to predict TB disease development. The dataset also contains data from six sub-studies.
Submitted by Kathryn Winglee, PhD, Lead Epidemiologist
DTBE - Authored Publications
Caruso E, Parmer J, Allen L, Maiuri A, Mangan J, Bouwkamp B, DeLuca N. Process and Outcome Evaluation of the Centers for Disease Control and Prevention's Think. Test. Treat TB Health Communications Campaign, United States, March-September 2022. Public Health Rep. 2024 Aug 27:333549241268644. doi: 10.1177/00333549241268644. Epub ahead of print. PMID: 39189099.
Filardo TD, Andrzejewski A, Croix M, Self JL, Fraimow HS, Munsiff SS. Epidemiology and Clinical Characteristics of Ocular Tuberculosis in the United States, 1993-2019. Open Forum Infect Dis. 2024 Aug 22;11(9):ofae476. doi: 10.1093/ofid/ofae476. PMID: 39282632; PMCID: PMC11393473.
Menzies NA, Swartwood NA, Cohen T, Marks SM, Maloney SA, Chappelle C, Miller JW, Beeler Asay GR, Date AA, Horsburgh CR, Salomon JA. The long-term effects of domestic and international tuberculosis service improvements on tuberculosis trends within the USA: a mathematical modelling study. Lancet Public Health. 2024 Aug;9(8):e573-e582. doi: 10.1016/S2468-2667(24)00150-6. PMID: 39095134.
Regan M, Barham T, Li Y, Swartwood NA, Beeler Asay GR, Cohen T, Horsburgh CR Jr, Khan A, Marks SM, Myles RL, Salomon JA, Self JL, Winston CA, Menzies NA. Risk factors underlying racial and ethnic disparities in tuberculosis diagnosis and treatment outcomes, 2011-19: a multiple mediation analysis of national surveillance data. Lancet Public Health. 2024 Aug;9(8):e564-e572. doi: 10.1016/S2468-2667(24)00151-8.
Swartwood NA, Li Y, Regan M, Marks SM, Barham T, Beeler Asay GR, Cohen T, Hill AN, Horsburgh CR Jr, Khan AD, McCree DH, Myles RL, Salomon JA, Self JL, Menzies NA. Estimated Health and Economic Outcomes of Racial and Ethnic Tuberculosis Disparities in US-Born Persons. JAMA Netw Open. 2024 Sep 3;7(9):e2431988. doi: 10.1001/jamanetworkopen.2024.31988. PMID: 39254977.
Xu AY, Velásquez GE, Zhang N, Chang VK, Phillips PP, Nahid P, Dorman SE, Kurbatova EV, Whitworth WC, Sizemore E, Bryant K, Carr W, Brown NE, Engle ML, Nhung NV, Nsubuga P, Diacon A, Dooley KE, Chaisson RE, Swindells S, Savic RM; Tuberculosis Trials Consortium (TBTC) Study 31/AIDS Clinical Trials Group (ACTG) A5349 study team. Pyrazinamide Safety, Efficacy, and Dosing for Treating Drug-Susceptible Pulmonary Tuberculosis: A Phase 3, Randomized, Controlled Clinical Trial. Am J Respir Crit Care Med. 2024 Jul 16. doi: 10.1164/rccm.202401-0165OC. Epub ahead of print. PMID: 39012226.