TB Elimination Heroes

Mike Sanders leads an exceptional team of EMS staff in Ventura County. They have operationalized new and innovative strategies to assist Ventura County Public Health (VCPH) TB Control in managing DOTs and field services.

This team partners with VCPH to travel during off hours, late at night, weekends, and holidays to observe active TB patients taking their meds and receiving care and services. Most recently their team assisted with non-compliant patients, difficult to find and/or DOT. Many of these patients have behavioral issues and recent incarcerations.  Despite these barriers the EMS team goes above and beyond to locate the patients and work with VCPH staff, family members, local law enforcement etc. to get patients and through care. One of these patients requires monthly EKGs, the EMS team continues to locate him and acquire monthly EKGs.

The EMS team exhibits resiliency and innovation in times of incredible fiscal restraints. They are not paid for these services, yet they continue to serve our community alongside VCPH. They are real heroes.

Starting in May, 2025, the Southern California Regional Community of Practice to End TB (CoP) and the Los Angeles County Office of Education (LACOE) have collaborated to advancing tuberculosis (TB) elimination in school age children in LA County through a revision of the Los Angeles County TK–12 School Entry TB Risk Assessment Requirement. This collaborative effort represents an innovative public health and education sector partnership designed to strengthen early TB prevention while promoting health equity for children and families across Los Angeles County and aligns with the CTCA guidance on school entry TB risk assessment for children in California.

The policy was developed to provide a mechanism for requiring a TB risk assessment for the pediatric population in LA County that was similar to the AB2132 requirement for adults in primary care settings. The policy requires completion of the Los Angeles County Pediatric TB Risk Assessment upon school entry, with the goal of encouraging families to engage with a primary care medical home for TB screening and follow-up care while ensuring that students are not excluded from school during the screening process unless they have symptoms suggestive of contagious TB disease. This approach prioritizes both public health and educational access, helping ensure that students at risk of TB infection can remain in school while receiving appropriate evaluation and care.

This initiative provides multiple prevention benefits: identifying students who may benefit from treatment for TB infection, encouraging evaluation of family members of children diagnosed with TB infection, and increasing awareness about TBprevention and treatment among families and healthcare providers.

The active involvement of LACOE school nurses and School Health Program Managers in shaping the policy has been critical to this effort. Their participation ensured that the policy was made more feasible for schools amidst existing limited resources and administrative burden by promoting regional pediatric provider education of the mandate through the CoP. Their experience navigating barriers faced by families helped to tailor resources aimed at promoting accessibility, such as the compiling of low or no cost community clinics. Their input directly informed the development of practical implementation guidance, parent and guardian education materials, and provider training resources.

Additionally, training LACOE school nurses to conduct TB risk assessments ensures that students without an established primary care provider or medical home can still be screened at school entry. At the same time, the policy encourages families to establish ongoing relationships with healthcare providers for further evaluation and care when needed.

In 2024, former Assemblyman Evan Low authored AB 2132, a landmark bill requiring primary care providers to conduct TB risk assessments and offer testing/linkage to care. This legislation was signed into law on September 30, 2024, supporting California’s TB elimination efforts by expanding TB screening and ensuring access to lifesaving treatment. AB 2132 also empowers advocates to seek state funding for implementation. As a dedicated TB champion, Mr. Low played a crucial role in educating legislators on TB-related health disparities and driving policy solutions to combat the epidemic.

Since November 2022, the Harbor UCLA (HUCLA) Pediatric Infectious Disease Clinic outreach team has collaborated with the Los Angeles County TB Control Program (TBCP) to provide essential TB infection treatment for newly arrived immigrant children in Southern Los Angeles County. Through referrals from the CDC and CDPH, the team ensures culturally sensitive, individualized care, including TB education, case management, and access to primary care and vaccinations.

To date, over 50 children have been referred, with 33 starting treatment and 26 completing it. By addressing TB infection in this transient population, the HUCLA team plays a critical role in preventing TB disease and fostering a community-driven approach to TB elimination in Southern California.

Jose has been an invaluable member of the San Diego County TB outreach team as their video producer for eight years. He has created a range of educational videos, including the “What is TB?” video, patient testimonials, and guides for chest x-rays, sputum collection, and video DOT recording. Working with native language narrators, he has translated videos into Spanish, Vietnamese, Mandarin, Tagalog, and Russian, making outreach accessible to diverse communities. Supported by the San Diego County Communications Office, Jose has also created videos for other California health jurisdictions, with many shared nationally, including by the CDC. Known for his enthusiasm and professionalism, Jose’s contributions have significantly advanced TB prevention and education.

Dr. Marytere Carrasquillo-Navarro is a dedicated TB Elimination Hero in Butte County, a semi-rural region with limited specialized healthcare providers. As an internal medicine and infectious disease specialist at multiple FQHC locations, she primarily manages HIV patients while also partnering with public health to treat TB cases, including those with HIV coinfection. She goes above and beyond, even using her lunch hours for case discussions to strategize patient care. Her work addresses TB care complexities, including chronic conditions, mental health, and socioeconomic barriers, ensuring equitable healthcare access. Butte County Public Health recognizes her unwavering commitment to advancing TB care and health equity in the community.

Central City Community Health Center’s outreach team has partnered with the Los Angeles County TB Control Program for 10 years, providing mobile primary care to non-US born, undocumented immigrants experiencing homelessness and undergoing substance use treatment. This partnership has been vital in responding to TB outbreaks, offering comprehensive TB testing and treatment services throughout the pandemic. Active surveillance has been conducted at five to eight Grupo sites since 2014, identifying 11 TB cases, evaluating 4,103 individuals, and testing 1,806, with annual TB positivity rates.

Dr. Fayette Truax has been a dedicated leader in TB prevention in Orange County, focusing on the high-risk Vietnamese population. As an Assistant Professor at Loma Linda University and a Pediatric Nurse Practitioner, she has led impactful quality improvement (QI) projects to enhance LTBI care. Her 2017–2018 initiative at Nhan Hoa Health Center significantly increased LTBI treatment rates from 7% to 72% within four months and improved the use of short-course treatment regimens. Currently, she is spearheading another QI project at Southland Health Center, supported by a TB Elimination Alliance mini-grant, incorporating culturally relevant patient education and provider training.