Dear Colleague Letters

Launch of the Tuberculosis Epidemiologic Studies Consortium (TBESC) III for the 2021–2026 Cycle

October 15, 2021

Dear Colleagues:

The Centers for Disease Control and Prevention is pleased to announce the launch of the Tuberculosis (TB) Epidemiologic Studies Consortium (TBESC) III for the 2021–2026 cycle. TBESC is a CDC-funded initiative to carry out observational epidemiologic research and related studies to improve identification, diagnosis, prevention, and control of TB disease and latent TB infection. TBESC is one of CDC’s flagship TB research consortia tasked with identifying approaches to accelerate TB elimination in the United States.

TBESC was established in 2001, with the first research cycle ending in 2011. TBESC-I conducted 29 studies via funding awarded to 22 sites and focused on studies ranging from the molecular epidemiology of multidrug-resistant TB disease to the cost of treating TB disease in urban health departments. The second TBESC research cycle began in 2011 and concluded in September 2021. Via funding awarded to 10 sites, TBESC-II conducted three significantly larger main studies focused on evaluating TB blood and skin tests, describing the latent TB infection care cascade, and identifying latent TB infection care cascade gaps, barriers, and facilitators. The primary study, one of the largest of its kind, compared the ability of the tuberculin skin test and interferon-gamma release assay to predict progression from latent TB infection to TB disease. Over the last two decades, TBESC studies have provided insight into how to improve public health programs’ capacity for preventing TB.

TBESC-III launched at the end of September 2021 and will lead to a better understanding of how TB infection screening, testing, and treatment is offered to patients in primary care settings, as well as the effectiveness and efficiency of potential public health interventions to increase the number of eligible patients who complete latent TB infection treatment. Epidemiologic modeling has demonstrated that the main driver of U.S. TB incidence is no longer recent transmission from infectious TB patients in the United States, but rather the large number of individuals (estimated as up to 13 million people) with latent TB infection who live in the United States but often acquired their TB infection elsewhere. TBESC-III researchers will:

  • Identify primary care settings that serve non-U.S.–born persons at elevated risk for TB infection,
  • Collect retrospective and prospective electronic medical record data,
  • Design and implement primary-care–based interventions to improve performance measures across the latent TB infection care cascade, and
  • Monitor and evaluate intervention performance over time to identify efficient and effective strategies to prevent TB disease.

The four organizations awarded contracts to conduct TBESC-III research are:

  • Denver Health and Hospital Authority – Principal Investigator (PI): Robert Belknap, MD;
  • Kaiser Foundation Research Institute – PI: Jacek Skarbinski, MD;
  • Public Health – Seattle & King County – PI: Masa Narita, MD; and
  • The Regents of the University of California, San Francisco – PI: Priya Shete, MD, MPH.

We look forward to working with the selected TBESC-III participants over the next 5 years to build upon the previous 20 years of TBESC research, as we continue to strive to eliminate TB in the United States.



Philip LoBue, MD, FACP, FCCP
Division of Tuberculosis Elimination
National Center for HIV, Viral Hepatitis, STD, and TB Prevention