General Overview: When looking at the number of new Tuberculosis  (TB) cases for Cabarrus County, the data would show a fluctuation of cases between 2 and 4 from years 2018 to 2024. This explains the local monitoring of the highly reportable, airborne communicable disease which is heavily tracked. However, the fluctuation of the number of new Tuberculosis cases depends on different factors that contributes to such change. Active TB (this indicator) is a North Carolina reportable disease. This is different from Latent TB (see performance measure below).  Latent TB can turn into active TB if it's not treated. 

Contributing Factors:

• Global Traveling and Migration:  Populations who are born outside the US or travel frequently to high risk countries (Asia, Africa, Latin America) have a higher risk to be exposed to Tuberculosis germs. Thus, immigration exams mainly screen for active TB disease to reduce the outbreak and spread of TB cases. 
• Covid-19 Pandemic: Around years 2020-2022, the increase in TB cases is mostly associated with COVID-19 pandemic, which caused a reduction in people's ability to access preventative services and routine TB screenings. 

Positive Factors:

• Case investigations and Contact Tracing:  When an active case is identified, Cabarrus Health Alliance communicable disease team interviews the patient to establish an exposure timeline, and proactively notifies, tests, and treats any close contacts
• Testing Services: The county offers localized testing for TB and provides specific preventative treatment for Latent TB Infection (LTBI) to prevent progression to active disease

Restricting Factors:

• Individual Factors: language barriers, lack of knowledge, and health behaviors. 
• Socioeconomic Factors: Limited access to healthcare services, lack of health insurance, and lack of transportation can prevent seeking TB treatment.  

Hint: List the partners and briefly describe the role that each will play to help turn the curve.

• Cabarrus Health Alliance: Cabarrus Health Alliance is responsible for providing Tuberculosis services to patients. The TB program helps detect persons with active and latent TB and treat them with effective anti-tuberculosis drugs. This stops the transmission of infection to other persons.

• Atrium Infectious Disease Services: Atrium Health provides communicable disease services in and around Cabarrus County related to prevention and treatment of diseases caused by tuberculosis.