Applying a new conceptual framework to evaluate tuberculosis surveillance and action performance and measure the costs, Hillsborough County, Florida, 2002.
OBJECTIVE
Tuberculosis (TB) elimination is an important US public health goal and improving the performance of TB surveillance and action and reducing the costs will help achieve it. But, there exists the need to better evaluate the performance and measure the costs.


METHODS
We pilot tested an evaluation strategy in Hillsborough County, Florida using a conceptual framework of TB surveillance and action with eight core and four support activities. To evaluate performance, we developed indicators and validated their accuracy, usefulness, and measurability. To measure the costs, we obtained financial information.


RESULTS
In 2001, Hillsborough County reported 78 (7%) of the 1145 Florida TB cases. Nineteen (24%) were previously arrested. While 13 (68%) of the 19 were incarcerated during the 2 years prior to being reported, only 1 (5%) of 19 was reported from the jail. From 111 TB suspects, 219 (25%) of 894 sputum specimens were inadequately collected. Of the $1.08 million annual budget, 22% went for surveillance, 29% for support, and 49% for action.


CONCLUSIONS
This conceptual framework allowed measurement of TB surveillance and action performance and cost. The evaluation performed using it revealed missed opportunities for detection of TB cases and wasted resources. This conceptual framework could serve as a model for evaluation of TB surveillance and action.
McNabb
Scott J N
SJ
Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Surdo
Alison M
AM
Redmond
Anne
A
Cobb
James
J
Wiley
Jennifer
J
Chakrabarti
Sumita
S
Duncan
Heather
H
Qualls
Noreen
N
Moore
Marisa
M
D003361:Cost Allocation; D017281:Cost of Illness; D005431:Florida / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D010865:Pilot Projects; D011159:Population Surveillance; D016730:Program Development; D015397:Program Evaluation; D011635:Public Health Administration / Q000191:economics*; D014376:Tuberculosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*