Development of a Surveillance Definition for United States–Mexico Binational Cases of Tuberculosis

Abstract

Objectives: Consistently collected binational surveillance data are important in advocating for resources to manage and treat binational cases of tuberculosis (TB). The objective of this study was to develop a surveillance definition for binational (United States–Mexico) cases of TB to assess the burden on US TB program resources. Methods: We collaborated with state and local TB program staff members in the United States to identify characteristics associated with binational cases of TB. We collected data on all cases of TB from 9 pilot sites in 5 states (Arizona, California, Colorado, New Mexico, and Texas) during January 1–June 30, 2014, that had at least 1 binational characteristic (eg, “crossed border while on TB treatment” and “received treatment in another country, coordinated by an established, US-funded, binational TB program”). A workgroup of US state, local, and federal partners reviewed results and used them to develop a practical surveillance definition. Results: The pilot sites reported 87 cases of TB with at least 1 binational characteristic during the project period. The workgroup drafted a proposed surveillance definition to include 2 binational characteristics: “crossed border while on TB treatment” (34 of 87 cases, 39%) and “received treatment in another country, coordinated by an established, US-funded, binational TB program” (26 of 87 cases, 30%). Applying the new proposed definition, 39 of 87 pilot cases of TB (45%) met the definition of binational. Conclusion: Input from partners who were responsible for the care and treatment of patients who cross the United States–Mexico border was crucial in defining a binational case of TB.