To the TB Community,
The Republic of the Marshall Islands (RMI) Department of Health will soon begin an island-wide TB screening and treatment project. The goal is to identify, evaluate and treat both active and latent TB infection (LTBI) cases among adults and children living on Majuro Island. The 24-week project will take place between June and September this year, with follow-up and treatment teams continuing to work until November 16, 2018.
This is quite an ambitious effort! We plan to screen more than 26,000 people to diagnose and treat TB in the Majuro community. The published rate of TB disease in Majuro is well over 300/100,000 - however, our work in neighboring Ebeye Island last year demonstrated a rate of nearly 800/100,000 among adults, increasing to 2,400/100,000 among adults with poorly controlled diabetes. In addition to finding and treating active TB, we will be testing (TST) and treating (3HP) all residents with LTBI. For children under age 2 years, we will use the 9H regimen for preventive therapy. Because of our experience in Ebeye, we will also add Hansen's Disease (HD) screening for all, and diabetes screening for adults found to have active TB, LTBI, or HD. For new TB cases that are infectious, we will also include a household contact investigation to ensure TB screening and TB prevention to exposed household members.
We are again seeking volunteer professionals to help us for this effort. We welcome trained individuals with significant TB experience who are willing to volunteer their time and energy for this innovative, large-scale project. These volunteers should be a mix of clinicians, nurses, lab techs, x-ray techs, and epi/data support. The RMI government, with approval from the U.S. Department of the Interior and the assistance of the Pacific Islands Health Officers Association (PIHOA), is offering to pay round-trip airfare (U.S. carriers), hotel (modest, but clean), and per diem for selected volunteers. Each volunteer is expected to provide at least three (3) weeks of high-intensity time to the 24-week project. No salary or honorarium will be paid.
This will be a unique "hands-on" effort integrating multi-disciplinary teams of experienced volunteers from the U.S. mainland, TB programs of the U.S.-Affiliated Pacific Islands, Department of Defense (DoD) staff, WHO staff, Pacific regional TB experts, and current Ebeye and Majuro TB program staff. The activities of volunteer staff will be equally divided between active TB case-finding, TB prevention, and working with the local TB program to provide further work-up, DOT, contact tracing, and DOPT when indicated. We will need 10 to 15 volunteers for each of the 3-week sessions.
The 3-week sessions in Majuro are scheduled as follows:
| Group: | A | B | C | D | E | F | G | H |
| Arrive: | 6/2 | 6/21 | 7/12 | 8/2 | 8/23 | 9/13 | 10/4 | 10/25 |
| Depart: | 6/22 | 7/13 | 8/3 | 8/24 | 9/14 | 10/5 | 10/26 | 11/16 |
Link to Invitation and Volunteer Positions
For more information please e-mail jon.warkentin@tn.gov.
Please consider this opportunity to help advance TB control in the U.S.-Affiliated Pacific Islands!
Sincerely,
Dick Brostrom, MD, MSPH
CDC TB Field Medical Officer, Pacific Islands
External Coordinator, TB+Leprosy Free Majuro
Jon Warkentin, MD, MPH
Med. Dir., Tennessee TB Elimination Program
Asst. Coordinator, TB Screening in Majuro