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October 2025
🔍Did You Know (DYK)?
NTIP Indicator of the Month – Sputum Culture Conversion
DYK the National Tuberculosis Indicators Project (NTIP) is a web-based tool that utilizes nationally set indicators to measure program progress toward achieving the National Tuberculosis (TB) Objectives? Using NTIP indicator reports, TB program officials prioritize prevention and care activities, as well as program evaluation. This month, the highlighted NTIP indicator focuses on documented sputum culture conversion within 60 days of treatment initiation for people with TB disease who have a positive sputum culture result.
Sputum culture conversion is a critical juncture in case management. Examining sputa on a regular basis helps: (i) detect possible treatment failure or detect early warning signs of relapse of TB disease; (ii) monitor patients with multidrug-resistant TB disease to ensure their infection continues to respond to treatment; (iii) determine length of treatment (the longer it takes to convert, the longer the length of treatment could be); and (iv) document that the person being treated no longer has TB disease at the end of planned treatment.
Sputum culture conversion means that a person with TB disease had a positive sputum culture before being treated for TB disease and at some point after starting treatment their sputum culture became negative. This conversion from positive to negative is the best way to measure how well a patient is responding to treatment and when achieved within the first 60 days of treatment will help determine the next treatment phase. Successful sputum culture conversion is usually defined as at least two consecutive negative cultures.
If a person with TB disease has severe illness, they are less likely to have sputum culture conversion within 60 days. It is important to continue to collect sputum until conversion is reached and documented so early action can be taken to understand why conversion might be slow. In some cases, a person being treated for TB may not be able to produce a sputum specimen after 2 months of treatment. In such situations, inducing sputum could be an option.
Washington State has consistently been above the national average when documenting sputum culture conversion over the past 5 years and exceeded the NTIP 2030 target of 80% for sputum culture conversion in 2022, 2023 and 2024. This consistent level of performance demonstrates Washington’s strong public health practices that reinforce the importance of achieving and documenting sputum culture conversion.
Questions about NTIP? Reach out the WA DOH TB Program at tbservices@doh.wa.gov.
🎉Celebrating the Retirement of 2 Dedicated TB Professionals
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Celebrating Xuan Man's Retirement
Congratulations to Xuan Man on her retirement! For those who may not know her, Xuan worked at the Tacoma-Pierce County Health Department for 31.5 years, serving as the Program Manager for the Refugee Health Program and, more recently, also taking on the role of TB Program Manager.
In her words, Xuan recounts how she was called to this work, the lessons she’s learned, and her hopes for the future of TB elimination.
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Xuan collaborated continuously with federal, state, and local partners to maximize efforts in locating, evaluating, screening, and connecting Class B arrivers with resources. She brought optimism and passion to her work, always adopting a human-centered approach. Xuan advocated for dedicated resources to successfully prevent TB disease spread and to ensure effective care, demonstrating her commitment to someday ending TB. She generously shared her expert knowledge and insights on the Class B process at various TB events, strengthening TB professionals' understanding of the unique processes and needs of Class B arrivers. Xuan’s thorough process and efforts led to an increased percentage of successful TB screening, evaluation, and treatment of Class B arrivers over the years. She always dedicated outstanding effort to ensure any recent arriver was connected with care.
In recognition of her dedication and impact, the WA DOH TB Program proudly nominated Xuan and she was recognized as a 2023 CDC U.S. TB Elimination Champion.
We wish Xuan all the best in this new chapter!
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Ann Lund’s Reflections on 18 Years as a TB Nurse
After 18 years as a TB nurse at Whatcom County Health Department, Ann Lund will be retiring. In this thoughtful reflection, she shares how she was drawn to TB work, the relationships and practices that shaped her career, insights on the future of TB, inspirations, and her post-retirement plans.
Ann represents the best of public health nursing. She views her patients as partners in both their treatment and public health, serving as their advocate. With deep caring and respect, she is always attentive to their challenges and strengths. She works collaboratively with patients to overcome cultural, language, financial, and social barriers, helping them effectively complete treatment and move toward healing.
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In a fragmented medical system, Ann steps in to coordinate care, ensuring no one is left behind. She is generous, curious, and intellectually rigorous. She brings a global perspective to her work as she nurtures teamwork and freely shares her knowledge.
Ann has been a valued colleague who will be greatly missed. Ann has always provided thoughtful and encouraging words to her peers and colleagues, and has a knack for seeing and honoring the work that goes into various types of TB-related public health activities. Her participation in our community will continue in a different way as she shifts her focus to joy and fun in retirement.
We are proud to recognize Ann's remarkable career and send her off with warm wishes for what lies ahead.
👏Appreciation for the King County Pharmacy Team
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October is National Pharmacy month!
Thank you to the staff at the Public Health - Seattle and King County Downtown Pharmacy. Their partnership with the DOH TB Program plays an essential role in helping patients with TB across the state gain access to lifesaving medications. The pharmacy team has been a reliable historic partner in achieving treatment equity for un- and under-insured patients with TB living anywhere in Washington.
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THANK YOU, Public Health - Seattle and King County Downtown Pharmacy, for your commitment and dedication to partnership resulting in easier TB medication access for the LHJ, tribal partners, and their patients with TB.
LHJ and tribal partners who would like to know more about the DOH TB Medications program, check out the TB Partners Medications SharePoint page.
✨TSTin4D and IGRAin4D Update
The TST4D and IGRAin4D decision aids have been updated. New features include:
- French translation
- Risk estimates when both Tuberculin Skin Test (TST) and an interferon gamma release assay (IGRA) are done
- Corrections based on user feedback
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More information here. Additional comments or questions can be directed to Dick.Menzies@McGill.ca
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