Tuberculosis Contact Investigations--United States, 2003-2012.

Mycobacterium tuberculosis is transmitted through the air from an infectious patient (index patient) to other persons (contacts) who share space. Exposure to M. tuberculosis can result in tuberculosis (TB) disease or latent TB infection (LTBI), which has no clinical symptoms or radiologic evidence of disease. The cycle of transmission can be ended by isolating and treating patients with TB disease, examining contacts, and treating LTBI to prevent progression to TB disease. CDC systematically collects aggregate data on contact investigations from the 50 states, the District of Columbia (DC), and Puerto Rico. Data from 2003-2012 were analyzed for trends in yields from contact investigations, in terms of numbers of contacts elicited and examined and the estimated number of TB cases averted through treatment of LTBI among contacts in 2012. During 2003-2012, the number of TB cases decreased, while the number of contacts listed per index patient with contacts elicited increased. In 2012, U.S. public health authorities reported 9,945 cases of TB disease (1) and 105,100 contacts. Among these contacts, 84,998 (80.9%) were examined; TB was diagnosed in 532 (0.6%) and LTBI in 15,411 (18.1%). Among contacts with LTBI, 10,137 (65.8%) started treatment, and 6,689 (43.4% of all contacts with LTBI) completed treatment. By investigating contacts in 2012, an estimated 128 TB cases (34% of all potential cases) over the initial 5 years were averted, but an additional 248 cases (66%) might have been averted if all potentially contagious TB patients had contacts elicited, all contacts were examined, and all infected contacts completed treatment. Enhancing contact investigation activities, particularly by ensuring completion of treatment by contacts recently infected with M. tuberculosis, is essential to achieve the goal of TB elimination.

Positive youth development linked with prevention in a Vietnamese American community: successes, challenges, and lessons learned.

PURPOSE: To describe a positive youth development program that was successfully designed and implemented in partnership with a Vietnamese American community and to provide insight into the types of outcomes that can result from such programs in similar communities. METHODS: In-depth interviews were conducted with Vietnamese community leaders (n = 8) and youth (n = 10) who were involved in a positive youth development program in Oklahoma City. Interviews were tape recorded, transcribed verbatim, and coded by two independent analysts. Data matrices were used to help identify major themes. RESULTS: Participants felt they had strengthened numerous assets as a result of involvement in the youth development program, including communication with parents or another adult, leadership skills, constructive use of free time, and positive peer influences. Some of the participants also reported establishment of a relationship with a nonparent adult, inclusion of community service in their aspirations for the future, and avoidance of high-risk behaviors owing to their involvement in the program. Both adults and youth felt that the Vietnamese community had changed its perception of youth as a result of increased involvement of young people in community service and cultural activities. CONCLUSION: Positive youth development is a promising prevention strategy that can be adapted to Vietnamese communities in the United States.