TB is an old, life-threatening bacteria. It kills one out of every 6 Californians who fall ill with TB. With effective treatments to prevent anyone from becoming sick from TB and TB spreading through families and communities, public health professionals continue to strive for primary prevention activities across California, finding those with a risk for TB, testing for TB and treating TB before it becomes active and makes anyone sick and contagious. The reactive nature of public health funding to combat threats like TB have limited public health efforts to reach into communities most often threated by TB to find those infected with TB and encourage treatment before disease develops.
To do this, we need statewide partners, working with us to empower public health departments to do primary TB prevention programming in their communities, finding those at risk for TB, among those identifying those who have TB in their bodies and encouraging those individuals to get treated for TB before TB makes them ill and threatens their lives and the lives of their family members and community members.
CTCA is prioritizing building relationships with partner organizations leading and serving communities at highest risk for TB in California and engaging them in the Coalition for a TB-free California. The first act of this new CTCA Executive Committee was to create the following Health Equity Statement in an effort to refocus ongoing efforts to aggressively address those communities disproportionately impacted by TB.
- The California TB Controllers Association is committed to creating the opportunity for optimal health for all Californians by working to eliminate barriers to TB diagnosis, treatment and prevention across California, prioritizing those communities disproportionately impacted by TB, while working to eliminate the threat of TB for all Californians.
CTCA leadership is putting more attention, more resources, and a greater focus on working with communities most impacted by TB to help us remove the threat of TB for all Californias. Join us in this work through the Contact Us button at the bottom of this page.
The virtual 2021 National TB Conference, Recalibration: TB Elimination Beyond COVID-19 began on Wednesday June 9th and ran Wednesdays and Fridays through July 23rd. This dynamic 11 session virtual conference delivered excellent content to nearly 1000 attendees, and those who register for the conference can access recorded sessions and earn CEs for this rich TB care and prevention content for a full year.
The opening session addressed what it will take and what we all can do to reboot ourselves and our TB programs in a post COVID-19 emergency response landscape, beyond the challenges of siphoned staff and the prolonged and persistent draining of energy and focus.
Please consider supporting the National TB Controllers Association and this virtual enduring event by registering through the link above and joining us in our efforts to eliminate the threat of TB.
On July 13, 2021, The Stop TB Partnership, a global network of organizations working to eliminate the threat of TB worldwide, launched an education campaign calling for a new, more effective vaccine for TB by 2025 because BCG is 100 years old this month and provides poor lifetime protection against TB. Leading advocates from the Stop TB Partnership explained why this is an important commitment right now on a Facebook Live Event recorded here.
The anchoring message of this campaign follows here:
The BCG vaccine—which was first administered on July 18, 1921, has proven effective against TB meningitis and in protecting against severe TB in infants and young children. However, it offers variable and mostly poor protection against lung disease in adolescents and adults, the populations that are more likely to spread TB in the community. Every year, an estimated 10 million people get sick with TB, the majority living in developing countries.
The Stop TB Partnership encourages everyone to participate in this social media campaign this year, sharing their campaign materials here.
CTCA’s Communication Committee members commit to joining this campaign on CTCA social media outlets over the next six months, starting with this post. Please join us in raising awareness about the limitations of the BCG vaccine and the need for better protection against TB.
Earlier this year, Ryan Clary, a seasoned Coalition Consultant relaunched the Coalition for a TB-Free California (CTC). The CTC is made up of members, leaders, and representatives of communities most impacted by TB in California, and partners from California public health departments. Ryan joins us as an experienced infectious disease control and prevention advocate, specifically working on Hep C, HIV/AIDS coalitions. Ryan will work with the CTC to bring together partners, leading and serving those disproportionately impacted by TB in California to increase routine screening for TB risks, routine testing for those with a risk for TB, and encouraging routine treatment for those with TB before it makes them sick. Together, we can eliminate the threat of TB and create a TB-free California for all. Find out more and join the Coalition for a TB-free California.
On May 6th, CTCA hosted an open call for new and existing members of the coalition. In addition to public health program staff, the following groups were present: Association of Asian Pacific Community Health Organizations (AAPCHO), Asian American Drug Abuse Program, Asian Americans Advancing Justice – Los Angeles, Asian Pacific Islander Health Forum, Breathe California, Bridging Group (Corrections/health care advocacy), California Black Health Network, California Hepatitis Alliance, San Francisco AIDS Foundation, Hepatitis C and Latino Health Programs, San Francisco Hep B Free, Urban Street Angels
During this first meeting, members discussed potential activities for the coalition. Partners wanted:
- access to brochures and fact sheets about TB for at risk individuals
- education for medical providers, like Project ECHO, focused on TB
- adaptation of the Hep B Coalition model for education, outreach and advocacy
- outreach to elected officials to keep them informed about TB; and
- more focus on the most vulnerable populations (e.g. those living in congregate settings such as prisons or jails)
And, on this call in May, a first relaunching action of the CTC was agreed upon, to educate California Delegates in Washington, D.C. about TB in their districts, and urging them to stay informed about TB by joining the Congressional Tuberculosis Elimination Caucus, co-chaired by Representative Ami Bera, MD (CA-07), Representative Don Young (AK-At Large), and Senator Sherrod Brown (OH) to stay informed about TB. The bulk of this letter follows below:
In April, the California TB Controllers Association (CTCA) and the Association of Asian Pacific Community Health Organizations (AAPCHO) hosted a webinar for public health staff and partner organizations to share up to date information about the impact of disease on California and those most at-risk for TB. The following details were shared:
- 1,703 Californians were diagnosed with tuberculosis in 2020.
- 84% of those diagnosed with tuberculosis in California in 2020 were born outside of the U.S.
- 52% identified as Asian American, Native Hawaiian, or Pacific Islander (AANHPI).
- There are more than 2 million individuals living with Latent Tuberculosis Infection (LTBI) and are likely unaware of it. A person with LTBI has no symptoms and is not contagious. However, LTBI can develop into active tuberculosis at any time.
- 85% of active tuberculosis diagnosed in California is due to LTBI progression, which is preventable.
- Preventing this deadly airborne infectious disease from threatening Californians requires identification and treatment of LTBI before it becomes active tuberculosis.
The coalition will meet monthly. If you’d like to be invited to future CTC meetings, please let us know through the Contact Us button at the bottom of the page.
The Association of Asian Pacific Community Health Organizations (AAPCHO) co-hosted a World TB Day webinar for TB elimination partners and public health TB program staff entitled The Tuberculosis Epidemic: Impact in California and Strategies to Reach Elimination on April 8th.
The meeting opened with introductions from co-host representatives, the current CTCA President and Orange County TB Program Manager Angelito Bravo, MD, and Joe Lee the Director of Strategic Initiatives and Partnerships at AAPCHO. For our first presentation, we heard from Jackie Cuen, CTCA TB Patient Peer Support Navigator, as she shared her story of TB diagnosis and treatment in San Diego County. After we heard from Jackie, we heard about the number and distribution of TB cases in California in 2020.
AAPCHO representative, Joe Lee, provided a comprehensive overview of their TB elimination strategies and efforts, explaining that AAPCHO provides advocacy, collaboration, and leadership to drive health equity for Asian Americans, Native Hawaiian and Pacific Islanders (AANHPI) who have been marginalized and minoritized. AAPCHO is addressing TB because, nationwide, nearly 35% of all TB cases reported each year in the U.S. are among the AANHPI communities. TB impacts the over 50 ethnic subgroups with more than 100 languages spoken differently. AAPCHO is closely examining which subgroups are most disproportionately impacted to better target their enhanced prevention services. AAPCHO created the TB Elimination Alliance (TEA), a coalition funded by the CDC to eliminate TB and LTBI inequities among AANHPI populations, through education, awareness raising, innovation to achieve health communities free of TB.
We are excited to continue to build on this partnership and work together to achieve TB elimination.
This webinar was recorded and can be accessed here.
Each year in March, the number of TB cases diagnosed the year before are reported to the public. Tracking TB diagnoses and subpopulations affected disproportionately directs public health department efforts statewide to allocate resources and strategies to prevent and control TB.
Below is a summary of TB by the numbers in California 2020:
There are more than 2 million Californians living with latent TB infection (LTBI). LTBI is when the TB bacteria are found in the body but not causing symptoms, illness and cannot be spread to others.
85% of those diagnosed with TB disease in California in 2020 developed TB from LTBI.
84% of those diagnosed with TB disease in California in 2020 were born outside of the U.S.
52% of those diagnosed with TB disease in California in 2020 were born in Asia.
40% of adult TB cases had diabetes, end stage renal disease, HIV infection, or another health condition that increases the likelihood that LTBI will progress to TB disease.
Only 20% of those with LTBI are aware that they are living with LTBI.
11 (1.0%) of those diagnosed with TB in California in 2020 had multidrug resistant (MDR) TB.
California has not seen an increase in MDR TB diagnoses since routine testing for TB drug sensitivity began in 1993.
If you want to know more about TB in your area, contact us.
Social Media and Light Up in Red Campaigns Updated and Relaunched
CTCA Communications Committee (CC) World TB Day (WTBD) 2021 preparations focused on simplifying the 3rd generation WTBD Toolkit. The Social Media Campaign was updated and focused on Twitter posts and the development of a guide for creating TikTok TB educational videos. Additionally, the Light Up the World in Red materials were updated.
The CTCA CC enthusiastically embraced a new CC member’s TikTok ideas and research. After several presentations to key CTCA committees, planning got underway. A CTCA TikTok Channel (EndTBCalifornia) was created and linked to the www.ctca.org homepage. A video theme was created, a magic wand challenge, asking participants to answer the question, “if you could make any fact about tuberculosis common knowledge to the public, what would you choose?”
Messages and instructions were created and distributed to California TB Controllers and communication staff by CTCA CC members in advance to assist with planning for individual video production and posting to TikTok on World TB Day. The CTCA CC shifted from planning to production as people volunteered to review the instructions and create demonstration videos. All of the resources are posted to the World TB Day page on www.ctca.org. This is a communication strategy we hope to continue to build on.
If you could make any fact about tuberculosis common knowledge to the public, what would you choose?
CTCA is excited to announce the arrival of Ryan Clary, a seasoned coalition consultant, with a background in infectious disease control efforts. He will be helping to grow the Coalition for a TB-Free California. Ryan joins us with a lot of experience in Hep C, HIV and AIDS coalition development and support. We are thrilled to have his help reaching out to partner organizations to remove barriers to TB diagnosis and preventive treatment to protect Californians from the threat of TB disease.
With Ryan’s help, we’ll work to bring together additional partners who are leading and serving those populations disproportionately impacted by TB in California. We want to bring COVID-19 innovations in public health to TB care and prevention efforts, to eliminate the threat of TB.
By partnering with private health care providers and other service and advocacy organizations, with a focus to improve the health and well being of those disproportionately impacted by TB, we aim to increase routine screening for TB risks, testing of those with a risk for TB, and treating those with latent TB infection (LTBI) before TB disease threatens their life and the lives of their families and friends.
TB Risk + Positive TB Test = Treatment to prevent TB disease.
TB is an old and enduring life-threatening bacterium, killing 10% of those TB makes sick. We have effective treatments, however, we are challenged by the current reactive nature of public health TB control and prevention efforts. True prevention requires finding and treating of those who are infected with TB before they are sick with TB disease to prevent illness. To do this, we need partners working to improve health outside of public health departments, statewide.
Together, we can eliminate the threat of TB and create a TB-free California for all.
Find outmode and join the Coalition for a TB-free California.
In January 2021, the CTCA Communications Committee (CC) Co-Chairs decided to launch a monthly journal club that takes place the hour before CC meetings. The journal club provides members with an opportunity to read the latest relevant publications for TB CC efforts. The initial meeting focused on the publication:
Shining a light on an invisible, dormant threat, Insights for developing a communications campaign to encourage testing and treatment of Latent Tuberculosis Infection, Fall 2020.
This report on latent TB infection (LTBI) messaging research, conducted among groups most impacted by TB in the U.S., is the first of its kind supported and released by the Centers for Disease Control and Prevention Division of TB Elimination. This report presented themes to explore further when raising awareness of the threat of TB disease, the risks for having LTBI and the ability to treat LTBI to prevent TB disease from developing.
José Rangel-Garibay, a Health Educator with the Los Angeles Department of Public Health and the mastermind of the CTCA CC Journal Club, led the next discussion about two brief articles: Public Health Messaging in an Era of Social Media and Evaluating the Potential Role of Social Media in Preventative Health Care. He demonstrated best practices for facilitating these discussions by selecting 2-5 pages to discuss, summarizing the articles, sharing their methods, target audience(s), findings/results, their limitations, potential applications for this group and any next steps. He further instructed that ideally articles would be distributed, and a volunteer facilitator secured, two weeks in advance of each meeting. Below is a list of the past articles used for the CC Journal Club:
Join the Journal Club through the Contact Us link below.
At the 2020 Fall TB Controllers Meeting in November, we briefly presented California requirements for Health Care Personnel (HCP) TB Screening and COVID-19 emergency response changes to these requirements.
Licensing and Certification and CalOSHA require routine TB screening of Health Care Personnel in California. Both have temporarily relaxed routine TB testing requirements to minimize potential exposure to COVID-19 during the extended emergency response. Our Health Care Personnel TB Screening resource page, located under “Guidance” on ctca.org, links to these posted changes. Though temporary, we hope that we can move into agreement with national guidance here in CA. The data proves this is the way to progress TB elimination efforts and protect HCP, working on the frontlines. It may be counter intuitive, but data show, routine testing does not provide any protection for HCP. Assessing risk, testing those at risk and treating TB infection provides HCP protection.
The Centers for Disease Control recommends risk-based testing of HCPl, based on specific job duties and a facility risk. CTCA waited a decade to endorse this change, after looking at HCP TB data. CTCA now enthusiastically endorses and promotes:
- TB testing at hire. IGRA for those with BCG history.
- If positive TB test plus risk for TB, and TB disease is ruled out, recommend treating for latent TB infection to prevent the development of TB disease.
Health Care Personnel TB Screening Information: