Investigating Tuberculosis Healthcare Use in Minnesota

MADMC is quantifying missed opportunities for treating latent tuberculosis (TB) and identifying promising points of clinical intervention with the aim of reducing tuberculosis in our communities. Latent TB infection (LTBI) is not a reportable disease, and public health agencies have limited capacity to identify and treat LTBI in Minnesota. However, individuals with LTBI are at risk of developing active TB. Once TB is active, disease complications can develop, and others can be infected. Furthermore, the financial consequences are substantial for patients, families, health care providers, and public health. Each case of active TB requires significant case investigation and contact tracing efforts. Early detection and treatment of LTBI is critical for preventing active TB.

Our Work

In collaboration with the Minnesota Department of Health and Michigan Department of Health and Human Services, our team is analyzing electronic health record data to identify key points of intervention to combat the rise in active TB cases. We are first evaluating the current landscape of latent and active TB within Minnesota health systems by assessing disease burden, history of treatment, and presence of high-risk comorbidities. Steps for care after a latent tuberculosis infection diagnosis are being identified to determine the rates at which patients follow through with LTBI care. We are then analyzing patterns of healthcare utilization leading up to an active TB diagnosis to understand where and how patients are interacting with health systems. Findings from this project will inform interventions to more quickly identify and treat patients with TB, thereby reducing the community, health care, and financial burden of TB in the region.