Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Table of Contents INTRODUCTION About the Alaska Tuberculosis Program Manual .............. 1.2 Purpose................................................................ 1.2 Audience .............................................................. 1.2 How to Use This Manual ........................ 1.3 Portable document format .................................... 1.3 Hyperlinks ............................................................ 1.3 Cross-references ................................................. 1.3 Forms ................................................................... 1.3 Bookmarks ........................................................... 1.4 Printing ................................................................. 1.5 Icons .................................................................... 1.6 Abbreviations ....................................................... 1.7 Purpose of Tuberculosis Control ........ 1.10 Alaska Statutes and Regulations on Tuberculosis Control .................................... 1.11 Objectives and Standards ................... 1.12 Quality of care .................................................... 1.12 National and state program objectives............... 1.13 National standards and recommendations ........ 1.17 Roles, Responsibilities, and Contact Information ............................. 1.18 State tuberculosis program staff ........................ 1.18 Local public health agencies .............................. 1.21 Private medical providers ................................... 1.21 Laboratories ....................................................... 1.22 Resources and References ................. 1.23 SURVEILLANCE Introduction ............................................. 2.2 Purpose................................................................ 2.2 Policy ................................................................... 2.5 State statutes and regulations ............................. 2.5 Reporting Tuberculosis ......................... 2.6 Reporting suspected or confirmed cases of tuberculosis to the Section of Epidemiology........ 2.9 Tuberculosis case information to report to the Alaska TB Program ........................................... 2.10 Data Collection ...................................... 2.12 Forms ................................................................ 2.12 Computerized tuberculosis registry ................... 2.12 Document retention ........................................... 2.13 Genotyping ............................................ 2.14 Dissemination and Evaluation ............. 2.15 References ............................................. 2.16 TARGETED TESTING FOR LATENT TUBERCULOSIS INFECTION Introduction ............................................. 3.2 Purpose ............................................................... 3.2 Policy ................................................................... 3.2 State laws and regulations .................................. 3.3 Tuberculin testing of school children ................... 3.3 High Risk Groups.................................... 3.4 When to Conduct Targeted Testing ...... 3.6 Approaches to increasing targeted testing and treatment for latent tuberculosis infection..... 3.6 Screening for latent tuberculosis infection in facilities................................................................ 3.7 Alaska program standards for health care facilities, staff and long term care facilities .......... 3.8 References ............................................... 3.9 B NOTIFICATIONS Introduction ............................................. 4.2 A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Table of Contents I Revised November 2012
Purpose................................................................ 4.2 Pre-arrival medical screening for tuberculosis ..... 4.2 Overseas screening of applicants for immigration .......................................................... 4.4 Policy ................................................................... 4.6 Follow-up of B1 and B2 Tuberculosis Arrivals ............................. 4.7 Division of Global Migration and Quarantine forms .................................................................... 4.7 Data entry ............................................................ 4.7 Patient follow-up .................................................. 4.8 Evaluation of B1 and B2 Tuberculosis Arrivals ............................. 4.9 Evaluation activities ............................................. 4.9 Treatment ........................................................... 4.11 Resources and References ................. 4.12 DIAGNOSIS OF TUBERCULOSIS DISEASE Introduction ............................................. 5.2 Purpose................................................................ 5.2 Policy ................................................................... 5.3 Forms ................................................................... 5.3 Tuberculosis Classification System ..... 5.4 High Risk Groups ................................... 5.5 Case Finding ........................................... 5.7 Identifying suspected tuberculosis cases............. 5.7 Follow-up on suspected cases of tuberculosis .... 5.9 Diagnosis of Tuberculosis Disease. ... 5.10 Medical history ................................................... 5.11 Human immunodeficiency virus screening ........ 5.13 Physical examination ......................................... 5.14 Tuberculin skin test and interferon gamma release assays ..................... 5.14 Chest radiography .............................................. 5.15 Bacteriologic examination .................................. 5.16 Resources and References ................. 5.19 TREATMENT OF TUBERCULOSIS DISEASE Introduction ............................................. 6.2 Purpose ............................................................... 6.2 Policy ................................................................... 6.2 Forms .................................................................. 6.3 Basic Treatment Principles .................... 6.4 Treatment Regimens and Dosages ....... 6.6 Regimens ............................................................ 6.6 Table 3: Four Treatment Regimens for Drugsusceptible Tuberculosis ..................................... 6.8 Dosages .............................................................. 6.9 Table 4: Doses of First-line Antituberculosis Drugs for Adults and Children ........................... 6.10 Duration of treatment......................................... 6.11 Figure 1: Treatment Algorithm for Drug-susceptible Tuberculosis in Adults ....................................... 6.12 Side Effects and Adverse Reactions................................ 6.13 Basic monitoring steps ...................................... 6.13 Reporting reactions ........................................... 6.21 Monitoring for side effects and adverse reactions by antituberculosis drug ..................... 6.21 Response to Treatment ........................ 6.22 Completion of Therapy ......................... 6.23 Figure 2: Management of Treatment Interruptions ...................................................... 6.24 Case Closing and End-of-Treatment Evaluation .............................................. 6.25 Post-Treatment Evaluation .................. 6.26 Treatment in Special Situations .......... 6.28 Drug-resistant tuberculosis................................ 6.28 Human immunodeficiency virus infection .......... 6.29 Alcoholism ......................................................... 6.30 Restarting Anti-TB Medications in Patients with Drug-induced Hepatitis ...................................... 6.32 Figure 3: Restarting Anti-TB Medications in Patients with Drug-induced Hepatitis............. 6.32 A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Table of Contents II Revised November 2012
- Page 1: Alaska Tuberculosis Program Manual
- Page 5 and 6: Monthly assessment of adherence ...
- Page 7 and 8: When to Expand a Contact Investigat
- Page 9 and 10: Introduction CONTENTS About the Ala
- Page 11 and 12: How to Use This Manual Portable Doc
- Page 13 and 14: Printing To access the print dialog
- Page 15 and 16: Abbreviations Refer to the list bel
- Page 17 and 18: QFT QuantiFERON ® -TB test QFT-G Q
- Page 19 and 20: Alaska Statutes and Regulations on
- Page 21 and 22: National and State Program Objectiv
- Page 23 and 24: Indicator 3 Thorough contact invest
- Page 25 and 26: National Standards and Recommendati
- Page 27 and 28: Roles and Responsibilities Contact
- Page 29 and 30: Local Public Health Agencies Table
- Page 31 and 32: Resources and References Resources
- Page 33 and 34: Introduction Purpose Use this secti
- Page 35 and 36: Contact investigation: Collecting,
- Page 37 and 38: Reporting Tuberculosis Detecting an
- Page 39 and 40: Prompt reporting (prior to culture
- Page 41 and 42: Use the Infectious Disease Report F
- Page 43 and 44: Data Collection Forms The following
- Page 45 and 46: Genotyping Genotyping is a useful t
- Page 47 and 48: References 1 ATS, CDC, IDSA. Contro
- Page 49 and 50: Introduction Purpose Use this secti
- Page 51 and 52: child or a person acting on behalf
Purpose................................................................ 4.2<br />
Pre-arrival medical screening for tuberculosis ..... 4.2<br />
Overseas screening <strong>of</strong> applicants for<br />
immigration .......................................................... 4.4<br />
Policy ................................................................... 4.6<br />
Follow-up <strong>of</strong> B1 and B2<br />
<strong>Tuberculosis</strong> Arrivals ............................. 4.7<br />
Division <strong>of</strong> Global Migration and Quarantine<br />
forms .................................................................... 4.7<br />
Data entry ............................................................ 4.7<br />
Patient follow-up .................................................. 4.8<br />
Evaluation <strong>of</strong> B1 and B2<br />
<strong>Tuberculosis</strong> Arrivals ............................. 4.9<br />
Evaluation activities ............................................. 4.9<br />
Treatment ........................................................... 4.11<br />
Resources and References ................. 4.12<br />
DIAGNOSIS OF<br />
TUBERCULOSIS DISEASE<br />
Introduction ............................................. 5.2<br />
Purpose................................................................ 5.2<br />
Policy ................................................................... 5.3<br />
Forms ................................................................... 5.3<br />
<strong>Tuberculosis</strong> Classification System ..... 5.4<br />
High Risk Groups ................................... 5.5<br />
Case Finding ........................................... 5.7<br />
Identifying suspected tuberculosis cases............. 5.7<br />
Follow-up on suspected cases <strong>of</strong> tuberculosis .... 5.9<br />
Diagnosis <strong>of</strong> <strong>Tuberculosis</strong> Disease. ... 5.10<br />
Medical history ................................................... 5.11<br />
Human immunodeficiency virus screening ........ 5.13<br />
Physical examination ......................................... 5.14<br />
Tuberculin skin test and<br />
interferon gamma release assays ..................... 5.14<br />
Chest radiography .............................................. 5.15<br />
Bacteriologic examination .................................. 5.16<br />
Resources and References ................. 5.19<br />
TREATMENT OF<br />
TUBERCULOSIS DISEASE<br />
Introduction ............................................. 6.2<br />
Purpose ............................................................... 6.2<br />
Policy ................................................................... 6.2<br />
Forms .................................................................. 6.3<br />
Basic Treatment Principles .................... 6.4<br />
Treatment Regimens and Dosages ....... 6.6<br />
Regimens ............................................................ 6.6<br />
Table 3: Four Treatment Regimens for Drugsusceptible<br />
<strong>Tuberculosis</strong> ..................................... 6.8<br />
Dosages .............................................................. 6.9<br />
Table 4: Doses <strong>of</strong> First-line Antituberculosis<br />
Drugs for Adults and Children ........................... 6.10<br />
Duration <strong>of</strong> treatment......................................... 6.11<br />
Figure 1: Treatment Algorithm for Drug-susceptible<br />
<strong>Tuberculosis</strong> in Adults ....................................... 6.12<br />
Side Effects and<br />
Adverse Reactions................................ 6.13<br />
Basic monitoring steps ...................................... 6.13<br />
Reporting reactions ........................................... 6.21<br />
Monitoring for side effects and adverse<br />
reactions by antituberculosis drug ..................... 6.21<br />
Response to Treatment ........................ 6.22<br />
Completion <strong>of</strong> Therapy ......................... 6.23<br />
Figure 2: Management <strong>of</strong> Treatment<br />
Interruptions ...................................................... 6.24<br />
Case Closing and End-<strong>of</strong>-Treatment<br />
Evaluation .............................................. 6.25<br />
Post-Treatment Evaluation .................. 6.26<br />
Treatment in Special Situations .......... 6.28<br />
Drug-resistant tuberculosis................................ 6.28<br />
Human immunodeficiency virus infection .......... 6.29<br />
Alcoholism ......................................................... 6.30<br />
Restarting Anti-TB Medications in Patients with<br />
Drug-induced Hepatitis ...................................... 6.32<br />
Figure 3: Restarting Anti-TB Medications<br />
in Patients with Drug-induced Hepatitis............. 6.32<br />
A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Table <strong>of</strong> Contents II<br />
Revised November 2012
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