1. New Tuberculosis Reports Melissa Ehman Epidemiologist California TB Controllers Association Meeting October 22, 2010

2. Topics for Today What are the new TB indicator reports?  TB Data Summary  National TB Indicators Project (NTIP)  B Notification Reports Who will receive them? How can they be used?

3. What is the TB Data Summary? Snapshot report of 9 key TB control measures Shows local and CA data + CA targets For local programs with ≥15 TB cases/year* TBCB assistance is available:  Epidemiologists can help interpret indicators, and produce line listings and additional analyses  Program liaisons can help initiate or integrate with existing program improvement efforts Pilot in 2010 – we want feedback! *3-year average, 2007-2009

4. TB Data Summary Indicators 1.TB Case Rate 2.U.S.-Born TB Case Rate 3.Genotyped Cases 4.Documented Culture Conversion (≤60 days) 5.Inappropriate Self-Administered Therapy 6.Completion of Treatment Ever 7.Deaths with TB 8.Contacts Evaluated 9.B notifications Evaluated

5. What is the National TB Indicators Project (NTIP)? Indicator set and online reports modeled after California TIP Framework for monitoring and evaluating Cooperative Agreement-funded TB programs (launched 2009) Set of national TB program objectives, with national performance targets for 2015 Now available for local programs with ≥15 TB cases/year

6. Current NTIP Indicators 1.Sputum Culture Reported 2.Drug Susceptibility Result 3.Universal Genotyping 4.Recommended Initial Therapy 5.Sputum Culture Conversion 6.Completion of Treatment 7.Data Reporting - RVCT 8.Contact Elicitation 9.Contact Evaluation 10.LTBI Treatment Initiation 11.LTBI Treatment Completion

7. B Notification Report Purpose  Understand trends/patters in B note arrivals  Inform activities at local programs Report available for the 22 local programs receiving 95% of California B note arrivers  Arrivals by B classification, country of origin  Domestic evaluation status  Outcome of domestic evaluation Feedback/comments are encouraged

8. Next Steps All Local Health Departments:  Stop by registration table to pick up state epidemiologist assignment list Local Health Departments with ≥15 cases:  Pick up your TB Data Summary, NTIP and B Notification reports Feedback on all indicator reports:  We will be requesting structured feedback  Contact Melissa Ehman re: TB Data Summary and NTIP reports MEhman@cdph.ca.govMEhman@cdph.ca.gov  Contact Phil Lowenthal re: B Notification Reports Phil.Lowenthal@cdph.ca.gov Phil.Lowenthal@cdph.ca.gov

9. Acknowledgements Report Development and Production James Watt Jenny Flood Janice Westenhouse Darryl Kong Phil Lowenthal Alex Golden Martin Cilnis  And thank you to CTCA Executive Committee for early feedback

10. California LHJs with ≥15 Cases/Year; TIP LHJs (≥55 Cases/Year) Alameda Contra Costa Fresno Kern Imperial Long Beach Los Angeles Monterey Orange Riverside Sacramento San Bernardino San Diego San Francisco San Joaquin San Mateo Santa Barbara Santa Clara Solano Stanislaus Tulare Ventura

11. California and National Data Reports: Audience and Purpose ReportAudiencePurpose CA TB Data Summary Local staff n≥15 cases Data for action Snapshot CA TB Indicators Project (TIP) Local staff n≥55 cases Starting point for program improvement process Indicators + data breakdowns CDC National TIP (NTIP) Local staff n≥15 cases Starting point for program improvement process Indicators + data breakdowns CA B notification Local staff n≥15 cases Data Descriptive data CA Annual Report on TB All local programs Public Reference From state perspective

12. NTIP Indicators: Data not yet available TB Case Rates  U.S.-born, foreign-born, African-American, children Known HIV Status Laboratory Reporting - Turnaround time Data Reporting – ARPE; EDN Treatment Initiation Evaluation of Immigrants and Refugees  Evaluation Initiation and Completion: Treatment Initiation and Completion

13. How do the TB Data Summaries and TIP reports compare to the NTIP reports? Some indicators have the same definition  Differences in calculations are being reconciled Some indicators are similar, but have key differences in definitions Some indicators are distinct to each set

14. Indicator Reconciliation Different underlying dataset  Acknowledge differences  Be clear about datasets used Different time period  Use comparable datasets when checking results Different calculations  Identify and fix errors  Match coding to CDC’s for consistency