PUBLIC HEALTH: Enhanced: A National Tuberculosis Archive

Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to “sink or sail with the general health services of the country.” The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called “Global Initiatives.” An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.

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Essential Components of a Public Health Tuberculosis Prevention, Control, and Elimination Program: Recommendations of the Advisory Council for the Elimination of Tuberculosis and the National Tuberculosis Controllers Association

MMWR Recommendations and Reports ◽

10.15585/mmwr.rr6907a1 ◽

2020 ◽

Vol 69 (7) ◽

pp. 1-27

Author(s):

Barbara Cole ◽

Diana M. Nilsen ◽

Lorna Will ◽

Sue C. Etkind ◽

Marcos Burgos ◽

...

Keyword(s):

Public Health ◽

Advisory Council ◽

Tuberculosis Prevention ◽

Essential Components ◽

National Tuberculosis

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Improving the Quality of Data Exchange Formats in the U.S. National Tuberculosis Surveillance System

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v10i1.8369 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Wilfred Bonney ◽

Sandy F Price ◽

Roque Miramontes

Keyword(s):

Public Health ◽

Surveillance System ◽

Surveillance Systems ◽

Test Results ◽

Snomed Ct ◽

Quality Of Data ◽

High Quality ◽

Laboratory Test Results ◽

National Tuberculosis

Objective: The objective of this presentation is to use a congruence of standardization protocols to effectively ensure that the quality of the data elements and exchange formats within the NTSS are optimal for users of the system.Introduction: Disease surveillance systems remain the best quality systems to rely on when standardized surveillance systems provide the best data to understand disease occurrence and trends. The United States National Tuberculosis Surveillance System (NTSS) contains reported tuberculosis (TB) cases provided by all 50 states, the District of Columbia (DC), New York City, Puerto Rico, and other U.S.-affiliated jurisdictions in the Pacific Ocean and Caribbean Sea [1]. However, the NTSS currently captures phenotypic drug susceptibility testing (DST) data and does not have the ability to collect the rapid molecular DST data generated by platforms such as Cepheid GeneXpert MTB/RIF, Hain MTBDRplus and MTBDRsl, Pyrosequencing, and Whole Genome Sequencing [2-6]. Moreover, the information exchanges within the NTSS (represented in HL7 v2.5.1 [7]) are missing critical segments for appropriately representing laboratory test results and data on microbiological specimens.Methods: The application of the standardization protocols involves: (a) the revision of the current Report of Verified Case of Tuberculosis (RCVT) form to include the collection of molecular DST data; (b) the enhancement of the TB Case Notification Message Mapping Guide (MMG) v2.03 [8] to include segments for appropriately reporting laboratory test results (i.e., using Logical Observation Identifiers Names and Codes (LOINC) as a recommended vocabulary) and microbiology related test results (i.e., using Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED CT) as a recommended vocabulary); and (c) the standardization of the laboratory testing results generated by the variety of molecular DST platforms, reported to TB health departments through electronic laboratory results (ELR), using those same standardized LOINC and SNOMED CT vocabularies in HL7 v2.5.1 [7].Results: The application of the standardization protocols would optimize early detection and reporting of rifampin-resistant TB cases; provide a high-quality data-driven decision-making process by public health administrators on TB cases; and generate high-quality datasets to enhance reporting or analyses of TB surveillance data and drug resistance.Conclusions: This study demonstrates that it is possible to apply standardized protocols to improve the quality of data, specifications and exchange formats within the NTSS, thereby streamlining the seamless exchange of TB incident cases in an integrated public health environment supporting TB surveillance, informatics, and translational research.

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Substantial underreporting of tuberculosis in West Greece - implications for local and national surveillance

Eurosurveillance ◽

10.2807/ese.14.11.19152-en ◽

2009 ◽

Vol 14 (11) ◽

Author(s):

E Jelastopulu ◽

E C Alexopoulos ◽

D Venieri ◽

G Tsiros ◽

G Komninou ◽

...

Keyword(s):

Public Health ◽

Incidence Rates ◽

Female Ratio ◽

Case Detection Rate ◽

Male Predominance ◽

Public Health Departments ◽

Male Female Ratio ◽

National Tuberculosis ◽

National Public Health ◽

The Face

In order to estimate the reliability of the officially reported national tuberculosis (TB) incidence rates we performed a retrospective review of data collected in regional and national public health framework. TB notifications for the period 2000-2003 were obtained from two major hospitals and three relevant Public Health Departments (PHDs) in the region of West Greece, and subsequently compared with the data reported to the Hellenic Centre for Diseases Control (KEELPNO). During the four-year study period a total of 161 cases of TB were reported to the PHDs in West Greece; 70% of these cases were reported to the KEELPNO. Furthermore only 72 (38.7%) out of the 186 cases of TB identified in the two hospitals were notified to the PHDs. Assuming that the degree of undernotification observed for the two hospitals is the same throughout the region, we estimated that the case detection rate was 14 cases per 100,000 persons per year, i.e. 3.7 times higher than the rate officially reported for the period 2000-2003. Male predominance (2.1, male/female ratio) and an increased incidence in the elders (older than 60 years) and adolescents (10-14 years old) were also evident. The study demonstrated a substantial underestimation of TB burden in West Greece. In the face of the massive influx of immigrants and refugees coming from regions with high TB incidence and the increase of the number of drug-resistant cases a reliable and complete notification of TB is crucial in the planning of programs and development of appropriate control policies.

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