Tuberculosis Epidemiologic Studies Consortium (TBESC)

TBESC-III: Implementing and Evaluating Interventions to Increase Treatment of Latent TB Infection in Primary Care Settings

The Tuberculosis Epidemiologic Studies Consortium (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. The current research cycle, known as TBESC-III, began in September 2021 and ends in March 2026.

Purpose

The purpose of TBESC-III is to assess the following:

  • How is latent TB infection screening, testing, and treatment offered to patients in primary care settings?
  • What is the impact of primary care interventions designed to increase the number of eligible patients who complete treatment for latent TB infection?

Research objectives

TBESC-III objectives include:

  • 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
  • Monitor and evaluate intervention performance over time to identify efficient and effective strategies to prevent TB disease

Study Sites

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.

TBESC-II

The TBESC-II research cycle began in 2011 and concluded in September 2021. TBESC-II focused on strategies and tools to increase diagnosis and treatment of latent TB infection in populations at high risk. Via funding awarded to 10 sites, TBESC-II conducted three main studies (with six sub-studies) evaluating TB blood and skin tests, describing the latent TB infection care cascade, and identifying latent TB infection care cascade gaps, barriers, and facilitators.

TBESC-I

TBESC was established in 2001, with the first research cycle ending in 2011. TBESC-I focused on programmatically relevant epidemiologic, behavioral, economic, laboratory, and operational research for TB prevention and control. TBESC-I conducted 29 studies on topics ranging from the molecular epidemiology of multidrug-resistant TB disease to the cost of TB disease in urban health departments.