Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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Resources and References General Case Management Resources Curry International Tuberculosis Center. Asking the Right Questions: A Visual Guide to Tuberculosis Case Management for Nurses (Curry International Tuberculosis Center website) 2010. Available at: http://www.currytbcenter.ucsf.edu/products/product_details.cfm?productID=ONL-14 CDC. Module 4: “Treatment of Latent Tuberculosis Infection and Tuberculosis Disease” (Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]; 2008). Available at: http://www.cdc.gov/tb/education/ssmodules/pdfs/Module4.pdf CDC. Module 9: “Patient Adherence to Tuberculosis Treatment “(Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]; 1999). Available at: http://www.cdc.gov/tb/education/ssmodules/pdfs/9.pdf California Department of Health Services (CDHS)/California Tuberculosis Controllers Association (CTCA). “TB Case Management—Core Components” (CDHS/CTCA Joint Guidelines [CTCA Web site]; November 2011). Available at: http://www.ctca.org/fileLibrary/file_238.pdf New Jersey Medical School National Tuberculosis Center. Tuberculosis Case Management for Nurses: Self-Study Modules (New Jersey Medical School Global Tuberculosis Institute Web site). Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm . Directly Observed Therapy Resources CDC. Chapter 7: “Treatment of Tuberculosis Disease” (Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]; Updated October 2004). Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm CDC. Module 9: “Patient Adherence to Tuberculosis Treatment” (Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]; 1999). Available at: http://www.cdc.gov/tb/education/ssmodules/pdfs/9.pdf Curry International Tuberculosis Center. Directly Observed Therapy (DOT) Training Curriculum for TB Control Programs (Curry International Tuberculosis Center Web site; 2003). Available at: http://www.currytbcenter.ucsf.edu/products/product_details.cfm?productID=EDP-07 Incentives and Enablers Resources CDC. “Adherence” in Chapter 7 “Treatment of Tuberculosis Disease” (Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]; Updated October 2004). Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm . A L A S K A T B P R O G R A M M A N U A L Case Management 10. 42 Revised November 2012
CDC. Module 9: “Patient Adherence to Tuberculosis Treatment” (Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]; 1999). Available at: http://www.cdc.gov/tb/education/ssmodules/pdfs/9.pdf References 1 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):32. 2 CDC. Module 9: patient adherence to tuberculosis treatment. Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]. 1999:3. Available at: http://www.cdc.gov/tb/education/ssmodules/module9/ss9contents.htm . Accessed January 8, 2011. 3 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):14. 4 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):17. 5 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):17. 6 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):1. 7 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):1–2. 8 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):1–2. 9 California Department of Health Services (CDHS)/California Tuberculosis Controllers Association (CTCA). TB case management—core components. CDHS/CTCA Joint Guidelines [CTCA Web site]. November 2011. Available at: http://www.ctca.org/fileLibrary/file_238.pdf . Accessed October 18, 2012. 10 California Department of Health Services (CDHS)/California Tuberculosis Controllers Association (CTCA). TB case management—core components. CDHS/CTCA Joint Guidelines [CTCA Web site]. November 2011. Available at: http://www.ctca.org/fileLibrary/file_238.pdf . Accessed October 18, 2012. 11 California Department of Health Services (CDHS)/California Tuberculosis Controllers Association (CTCA). TB case management—core components. CDHS/CTCA Joint Guidelines [CTCA Web site]. November 2011. Available at: http://www.ctca.org/fileLibrary/file_238.pdf . Accessed October 18, 2012. 12 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 13 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 14 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 15 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 16 CDC. TB Infection Control in Chapter 7. Treatment of Tuberculosis Disease in Core Curriculum on Tuberculosis (2011) [Division of Tuberculosis Elimination Web site]. Updated 2011. Available at: http://www.cdc.gov/tb/education/corecurr/pdf/corecurr_all.pdf. 17 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 18 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis Institute Web site]. (no year):8. Available at: http://www.umdnj.edu/globaltb/products/tbcasemgmtmodules.htm. Accessed January 8, 2011. 19 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):25. 20 New Jersey Medical School National Tuberculosis Center. Module 2: fundamentals of TB case management. Tuberculosis Case Management for Nurses: Self-Study Modules [New Jersey Medical School Global Tuberculosis A L A S K A T B P R O G R A M M A N U A L Case Management 10. 43 Revised November 2012
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Alaska Tuberculosis Program Manual
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Purpose............................
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Monthly assessment of adherence ...
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When to Expand a Contact Investigat
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Introduction CONTENTS About the Ala
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How to Use This Manual Portable Doc
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Printing To access the print dialog
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Abbreviations Refer to the list bel
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QFT QuantiFERON ® -TB test QFT-G Q
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Alaska Statutes and Regulations on
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National and State Program Objectiv
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Indicator 3 Thorough contact invest
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National Standards and Recommendati
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Roles and Responsibilities Contact
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Local Public Health Agencies Table
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Resources and References Resources
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Introduction Purpose Use this secti
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Contact investigation: Collecting,
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Reporting Tuberculosis Detecting an
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Prompt reporting (prior to culture
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Use the Infectious Disease Report F
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Data Collection Forms The following
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Genotyping Genotyping is a useful t
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References 1 ATS, CDC, IDSA. Contro
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child or a person acting on behalf
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When to Conduct Targeted Testing Al
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Alaska Program Standards for Health
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B Notifications CONTENTS Introducti
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Table 1: NUMBERS OF FOREIGN-BORN PE
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chest radiograph and if sputum AFB
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Follow-up of B1 and B2 Tuberculosis
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Evaluation of B1, B2, and B Tubercu
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Treatment Prescribe medications as
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12 Centers for Disease Control and
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Tuberculosis Classification System
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Table 2: PERSONS AT HIGH RISK FOR T
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Table 3: WHEN TO SUSPECT PULMONARY
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Diagnosis of Tuberculosis Disease T
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1. Exposure to Infectious TB: Ask p
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Physical Examination A physical exa
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For more information on chest radio
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Laboratories should report positive
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Guidelines for preventing the trans
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50 CDC. National plan for reliable
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Introduction Purpose The overall go
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Basic Treatment Principles Follow t
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Treatment Regimens and Dosages Use
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Table 3: FOUR TREATMENT REGIMENS FO
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† 4 Table 4: DOSES*OF FIRST-LINE
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Figure 1:TREATMENT ALGORITHM FOR DR
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a. In remote locations in Alaska, m
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Antituberculosis Drug Rifampin (RIF
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Antituberculosis Drug Rifapentine (
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Reporting Reactions The table below
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Response to Treatment For consultat
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Figure 2: MANAGEMENT OF TREATMENT I
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Post-Treatment Evaluation Routine f
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Treatment in Special Situations Tre
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Resources For consultation regardin
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with an increase in overall complet
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Liver Disease Management of TB in p
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After the initial phase (first two
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Extrapulmonary Tuberculosis The bas
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Diagnosis of Latent Tuberculosis In
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Forms All required and recommended
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High-Risk Groups Certain factors id
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Diagnosis of Latent Tuberculosis In
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continually exposed to populations
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Administration of the Tuberculin Sk
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See “Two-Step Tuberculin Skin Tes
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See “Live-Virus Vaccines” under
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For more information on IGRAs and t
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Table 5: TARGETED TESTING FOR LATEN
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Treatment of Latent Tuberculosis In
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Policy Detailed information on the
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Window period prophylaxis is treatm
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Regimens Identify an appropriate re
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Dosages Once the appropriate regime
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Side Effects and Adverse Reactions
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If a patient reports to a healthcar
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Antituberculosis Drug Rifampin (RIF
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DOT is strongly encouraged for thos
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Table 7 describes the duration of t
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Alcoholism Alcohol-Related Treatmen
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Medication Administration and Pharm
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National Tuberculosis Controllers A
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24 CDC . “Recommendations for Use
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Diagnosis and Treatment of Latent T
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All children suspected or diagnosed
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Latent Tuberculosis Infection (LTBI
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History of BCG vaccination is not a
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Because of their higher specificity
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Table 3: COUNTRIES AND AREAS WITH A
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Treatment of Latent TB Infection (L
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For consultation regarding the trea
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Monitoring DOT is mandatory for INH
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For young infants, some experts rec
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TABLE 8: SIGNS AND SYMPTOMS OF PULM
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Treatment of Tuberculosis Basic pri
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Regime n 1 2 3 ❺ Table 10: FOUR T
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Page 211 and 212: Monitoring Response to Treatment Ch
Page 213 and 214: Child Care and Schools: Children wi
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Page 219 and 220: Case Management CONTENTS Introducti
Page 221 and 222: patient-centered approach to case m
Page 223 and 224: Alaska TB Program: Timeline for the
Page 225 and 226: For assistance with language issues
Page 227 and 228: Ascertain the extent of TB illness
Page 229 and 230: medical/health problem. The date of
Page 231 and 232: necessary to teach people how to ta
Page 233 and 234: Treatment Plan Components Recommend
Page 235 and 236: Implementation Activities To begin
Page 237 and 238: o Indicate the number of doses prov
Page 239 and 240: Review the status of the contact in
Page 241 and 242: For more information, see the “Di
Page 243 and 244: importance of continued treatment a
Page 245 and 246: 5. Review information with the prov
Page 247 and 248: Completion of Therapy The case mana
Page 249 and 250: Case Closures Other than Completion
Page 251 and 252: Conduct a case management meeting o
Page 253 and 254: Biweekly (BIW) doses of TB medicati
Page 255 and 256: Use DOT with other measures such as
Page 257 and 258: It is important not to send a mixed
Page 259: Medical Orders Progressive Interven
Page 263 and 264: 36 New Jersey Medical School Nation
Page 265 and 266: 75 CDC. Module 9: patient adherence
Page 267 and 268: Introduction Purpose A contact inve
Page 269 and 270: For roles and responsibilities, ref
Page 271 and 272: Decision to Initiate a Contact Inve
Page 273 and 274: chest radiographic findings that ar
Page 275 and 276: In general, a contact investigation
Page 277 and 278: Time Frames for Contact Investigati
Page 279 and 280: Circumstances unique to Alaska may
Page 281 and 282: Circumstances unique to Alaska may
Page 283 and 284: Activity Purpose Maximum Time Inter
Page 285 and 286: Infectious Period Determine the inf
Page 287 and 288: In general, for the purposes of con
Page 289 and 290: General Guidelines for Interviewing
Page 291 and 292: Healthcare workers should remember
Page 293 and 294: Index Patient with Positive Acid-Fa
Page 295 and 296: Index Patient with Negative Acid-Fa
Page 297 and 298: Contact Evaluation, Treatment, and
Page 299 and 300: Definition of abbreviations: HIV =
Page 301 and 302: Note: An IGRA may be used in place
Page 303 and 304: When to Expand a Contact Investigat
Page 305 and 306: Figure 7: EVALUATION, TREATMENT, AN
Page 307 and 308: CDC’s “Framework of Program Eva
Page 309 and 310: Definitions of abbreviations: AIDS
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elease assay; LTBI = latent tubercu
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officials to distinguish between di
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References 1 ATS, CDC, IDSA. Contro
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44 CDC, NTCA. Guidelines for the in
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Available Laboratory Tests Table 2:
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Table 3: PCR Testing Algorithm and
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Table 4: SPECIMEN COLLECTION METHOD
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5. If possible, send the specimen o
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Specimen Shipment There are three m
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Patient Education CONTENTS Introduc
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treatment, common side-effects of m
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Education Topics During the initial
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10. Explain the signs and symptoms
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Patient Education Materials Get th
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References 1 CDC. Module 4: treatme
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National Guidelines The following g
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Transfer Notifications CONTENTS Int
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For roles and responsibilities, ref
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Follow-Up Type When to Initiate Not
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Action Transfers Within Alaska Tran
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Provide the patient with a. A copy
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References 1 CDC. International not
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Infection Control CONTENTS Introduc
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of TB infection control principles
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Administrative Activities 13 Key ac
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Personal Respiratory Protection Alt
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For regulations in your area, refer
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Employee Health All employees, phys
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Figure 1: TWO STEP TESTING AND FOLL
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Isolation To reduce disease transmi
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Table 4: CRITERIA FOR PATIENTS TO B
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When to Initiate Airborne Infection
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Confirmed Tuberculosis Disease A pa
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Multidrug-Resistant Tuberculosis Di
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Environmental Controls in the Patie
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Return to Work, School, or Other So
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Tuberculosis Infection Control in P
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Transportation Vehicles To prevent
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7 CDC. Guidelines for preventing th
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Forms: Alaska State Public Health L
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ALASKA STATE PUBLIC HEALTH LABORATO
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Anchorage Alaska State Public Healt
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INDEX CASE INFORMATION Name: DOB: /
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CONTACT Name: Tuberculosis Contact
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Directly Observed Therapy (DOT) Cal
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B. Documents patient care activitie
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Alaska TB Program Section of Epidem
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Treatment Summary for Active TB Nam
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Interjurisdictional Tuberculosis No
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Latent Tuberculosis Infection (LTBI
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Alaska Tuberculosis Program 9210 Va
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Instructions for Collecting Sputum
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TB Case Management Information Requ
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Table 1: First-line anti-tuberculos
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Return the fax to the Drug Room (90
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Stock Orders: A small supply of
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TB/LTBI Medication Return Form Reas
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TB/LTBI Stock Medication Request FA
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TB Medication Dose Monitoring Regim
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TB Medication Dose Monitoring Regim
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ALASKA DEPARTMENT OF HEALTH AND SOC
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Tuberculosis Discharge Planning Che
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PART 2: 8. Have you ever been told
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Tuberculosis Treatment Contract Dep
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Statutes and Regulations Contents I
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Regulations Infection Control 7 AAC
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place of work is remote from patien
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(2) the child or a person acting on
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Glossary acid-fast bacilli (AFB): M
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eaction size on a later test, which
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disseminated TB: See miliary TB. dr
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immunocompromised and immunosuppres
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include medical history and TB symp
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thousands to millions of copies of
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secondary (TB) case: A new case of
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eproducing TB organisms from respir
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