CDC's Response to Ending Neglect

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The Plan

GOAL VI: Track progress

Monitor progress toward the goal of TB elimination, and make regular reports on progress to all target audiences.

Objective VI-A

Develop innovative analyses for examining surveillance data to help focus elimination efforts.

Traditional analyses of surveillance data provide basic descriptive epidemiology, including case counts and case rates by time, place, and case characteristics. Since 1993, the expanded TB case report has provided additional information on TB risk factors, such as HIV status, initial drug resistance, and treatment. These additional data elements have enhanced the ability at local, state, and national levels to describe high-risk populations and assess program efforts to ensure prompt and appropriate treatment for active cases. To better focus elimination efforts, innovative analyses to supplement traditional analyses will be needed. For example, the development of a definition of elimination for areas where annual case counts are very low (e.g., <10) and population size fairly small (e.g., <100,000) will help pinpoint regions on track for elimination.

Activities

1. Convene CDC work group(s) to define areas where innovative analyses would be most useful and to devise strategies for development and implementation.
2. Conduct and disseminate the results of innovative analyses to better focus elimination efforts.

Objective VI-B

Develop novel indicators of progress toward elimination.

Traditional program indicators included annual incident case counts and case rates, estimates of primary and acquired drug resistance, and completion-of-therapy rates. Recently developed indicators of successful contact investigations and targeted testing include completion-of-therapy rates for persons identified with latent TB infection. As areas progress toward elimination, further development of novel indicators will be essential.

Activities

1. Develop a CDC unit to work with partners from local, state, and federal levels to periodically review standard indicators and develop new indicators for use in measuring progress toward elimination.
2. Develop meaningful and useful reports for program officials and policy makers highlighting national progress using these standard indicators.

Objective VI-C

Conduct periodic evaluations of TB program performance at federal, state, and local levels.

An important part of TB control efforts is continuous evaluation of the effectiveness of control programs. Program evaluations provide 1) a feedback loop for data that can be used to refine operations and procedures, 2) a rational basis for decisions about the relative value of particular activities, and 3) information about ways to improve specific aspects of a given program. Evaluations force persons close to a program to step back and examine their efforts objectively. This is especially useful for well-intentioned programs that may be more concerned about addressing the immediate TB treatment and control needs in their communities than in determining the best ways to meet those needs. Methods to identify and correct problems in TB control programs and systems must be developed before they result in the further spread of TB disease and the development of drug-resistant TB.

Activities

1. Develop guidelines and standards for TB program evaluation.
• Conduct research to identify best methods for the evaluation of TB programs.
• Work with national organizations (e.g., ACET, NTCA, NCET) to develop guidelines and standards for TB program evaluation.
• Disseminate guidelines and standards to state and local TB programs.
• Incorporate evaluation as a core component of TB prevention and control programs.
2. Develop the capacity for program evaluation at the federal, state, and local levels.
• Develop training in evaluation methods and techniques.
• Provide ongoing technical assistance in program evaluation.
• Develop information management systems to facilitate program evaluation.
• Provide funding for program evaluation, utilizing the results for strategic planning and program enhancement.

Objective VI-D

Conduct an annual progress review.

Activities

1. Prepare annual progress reports for review by ACET and NTCA.

Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

 
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