Strengthening Civil Surgeons' Capacity to Improve LTBI Surveillance and Outcomes Among Status Adjusters

The Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) anticipates the availability of fiscal year 2022 cooperative agreement funds for a pilot project that will improve public health surveillance of latent TB infection (LTBI) among noncitizens residing in the United States on temporary visas who are applying for legal permanent residency (hereafter referred to as Status Adjusters) and improve Status Adjusters’ linkage to LTBI care and treatment through health departments’ collaboration with Civil Surgeons (US Citizenship and Immigration Services-authorized physicians who complete the required medical exam for Status Adjusters). CDC anticipates funding three recipients to work with Civil Surgeons within a state/local health department’s jurisdiction to enhance the quality and completeness of data reported to the health department for Status Adjusters diagnosed with LTBI. The recipients will also develop, implement, and evaluate an education/training/communication intervention that increases awareness of LTBI, as well as the number of Status Adjusters who are offered and accept treatment to prevent development of TB disease. In the United States, around 71% of TB disease cases occur in persons who are non-U.S.–born, and only about 13% of TB disease cases are related to recent transmission, meaning the overwhelming majority occur when someone with longstanding LTBI progresses to TB disease. Since they are non-U.S.–born, Status Adjusters are at higher risk for LTBI and development of TB disease. Improving awareness of and linkage to LTBI treatment among the Status Adjuster population is an important disease prevention opportunity.