Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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General Guidelines Table 1: GUIDELINES FOR THE EDUCATIONAL PROCESS When Educating Tuberculosis Patients Do Don’t Find out what patients know and believe about tuberculosis (TB). Reinforce and provide correct TB information, and disabuse them of any misconceptions. Use good skills to interview and influence patients, and to problem solve. Go through the educational material with patients. Use language appropriate to their level of understanding. If necessary, use an interpreter. Flood patients with information about TB and its effects without allowing them to participate in the discussion. Hand out pamphlets and brochures to patients without going through the materials with them. A L A S K A T U B E R C U L O S I S C O N T R O L P R O G R A M M A N U A L Patient Education 13.4 Revised November 2012
Education Topics During the initial assessment, directly observed therapy (DOT) appointments, and monthly monitoring, educate the patient as needed on the topics that follow. For more information on case management activities, see the Case Management section 10.1. Language and Comprehension Barriers In the initial assessment, assess for and address any potential language and comprehension barriers. 1. Assess the patient’s ability to speak and understand instructions, including potential barriers, such as not speaking English as primary language, deafness, speech deficit, or learning disability. 2. Assess literacy in the patient’s primary language. 3. Provide all instructions and communications in the appropriate language. 4. Use interpreters, visuals, or other educational methods to promote understanding. 5. Provide educational materials appropriate to the patient’s language and reading level. 6. Make referrals to an appropriate service and notify it of any language and comprehension concerns. For more information on cultural sensitivity, refer to the Participant’s Workbook for Session 4: “Working with Culturally Diverse Populations” in the Directly Observed Therapy Training Curriculum for TB Control Programs (Francis J. Curry National Tuberculosis Center Web site; 2003) at http://www.nationaltbcenter.edu/catalogue/epub/index.cfm?uniqueID=8&t ableName=DOTE . For information on country-specific TB epidemiology, common misperceptions, beliefs, attitudes, and stigmatizing practices related to TB and HIV/AIDS, general practices and cultural courtesies, translated educational materials available online, and references, refer to: https://sntc.medicine.ufl.edu/Files/Products/Intro.pdf Country-specific guides can be found at: http://sntc.medicine.ufl.edu/Products.aspx A L A S K A T U B E R C U L O S I S C O N T R O L P R O G R A M M A N U A L Patient Education 13.5 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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† 35 Table 11: DOSES*OF FIRST-LIN
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Monitoring Response to Treatment Ch
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Child Care and Schools: Children wi
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Other TB medications are not commer
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10 Centers for Disease Control and
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Case Management CONTENTS Introducti
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patient-centered approach to case m
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Alaska TB Program: Timeline for the
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For assistance with language issues
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Ascertain the extent of TB illness
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medical/health problem. The date of
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necessary to teach people how to ta
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Treatment Plan Components Recommend
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Implementation Activities To begin
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o Indicate the number of doses prov
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Review the status of the contact in
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For more information, see the “Di
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importance of continued treatment a
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5. Review information with the prov
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Completion of Therapy The case mana
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Case Closures Other than Completion
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Conduct a case management meeting o
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Biweekly (BIW) doses of TB medicati
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Use DOT with other measures such as
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It is important not to send a mixed
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Medical Orders Progressive Interven
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CDC. Module 9: “Patient Adherence
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36 New Jersey Medical School Nation
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75 CDC. Module 9: patient adherence
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Introduction Purpose A contact inve
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For roles and responsibilities, ref
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Decision to Initiate a Contact Inve
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chest radiographic findings that ar
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In general, a contact investigation
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Time Frames for Contact Investigati
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Circumstances unique to Alaska may
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Circumstances unique to Alaska may
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Activity Purpose Maximum Time Inter
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Page 287 and 288: In general, for the purposes of con
Page 289 and 290: General Guidelines for Interviewing
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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
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Page 309 and 310: Definitions of abbreviations: AIDS
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Page 313 and 314: officials to distinguish between di
Page 315 and 316: References 1 ATS, CDC, IDSA. Contro
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Page 319 and 320: Introduction Purpose Use this secti
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Page 323 and 324: Table 3: PCR Testing Algorithm and
Page 325 and 326: Table 4: SPECIMEN COLLECTION METHOD
Page 327 and 328: 5. If possible, send the specimen o
Page 329 and 330: Specimen Shipment There are three m
Page 331 and 332: Resources and References Resources
Page 333 and 334: Patient Education CONTENTS Introduc
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Page 339 and 340: 10. Explain the signs and symptoms
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Page 343 and 344: References 1 CDC. Module 4: treatme
Page 345 and 346: Introduction Purpose Use this secti
Page 347 and 348: National Guidelines The following g
Page 349 and 350: Transfer Notifications CONTENTS Int
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Page 353 and 354: Follow-Up Type When to Initiate Not
Page 355 and 356: Action Transfers Within Alaska Tran
Page 357 and 358: Provide the patient with a. A copy
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Page 361 and 362: Infection Control CONTENTS Introduc
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Page 375 and 376: Isolation To reduce disease transmi
Page 377 and 378: Table 4: CRITERIA FOR PATIENTS TO B
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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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Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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