302003
Enhancing infection control and surveillance for vulnerable populations: Response to the 2013 Metro Los Angeles tuberculosis outbreak for people living with HIV/AIDS
The Los Angeles Metro Region encompasses a large homeless population. In 2013, LA officials announced an outbreak of a unique strain of tuberculosis on Skid Row where many homeless can be found. Sixty of the 78 infections were among the homeless with 11 fatalities since 2007. Of the eight people living with HIV/AIDS (PLWHA) infected with this strain, 75% died. The outbreak became a focus of local, state and federal public health agencies.
AIDS Healthcare Foundation (AHF) operates 11 primary care health centers and two health plans in LA County. As an organizational response to this community level public health threat, AHF took a rapid, proactive approach to enhance TB surveillance and treatment among primary care patients, Ryan White (RW) clients and health plan members.
Description
The approach was multi-pronged. A detailed notification was sent via Fax Blast to 633 local healthcare providers. There were 4067 AHF clients identified with no TB test recorded for the preceding six months; testing postcard reminders were sent. There were 276 clients living within a 5 mile radius of the epicenter for targeted telephonic outreach by clinicians. RW clients and health plan members were targeted for focused outreach by care management staff.
Lessons Learned
Analysis found a 33% increase in TB surveillance in the 6 month period pre and post interventions. No significant increase in incidence was discovered.
Conclusion
PLWHA are particularly vulnerable to syndemic TB infection. Targeted outreach is effective for increasing TB surveillance and treatment in a highly-impacted region with outbreaks.
Learning Areas:
Administer health education strategies, interventions and programsProtection of the public in relation to communicable diseases including prevention or control
Learning Objectives:
List ways a community based organization can enhance disease surveillance in an outbreak environment.
Describe 2 means by which tuberculosis and HIV act to provide a syndemic relationship.
Keyword(s): Tuberculosis, HIV Interventions
Qualified on the content I am responsible for because: I have been involved in providing education and health promotion interventions for PLWHA throughout my career in public health. My work in the field of HIV/AIDS has concentrated in the primary, secondary and tertiary prevention of comorbid chronic and infectious disease.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.