Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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Alaska Tuberculosis Program Manual
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Purpose............................
Page 5 and 6:
Monthly assessment of adherence ...
Page 7 and 8:
When to Expand a Contact Investigat
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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
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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
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
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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
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Genotyping Genotyping is a useful t
Page 47 and 48:
References 1 ATS, CDC, IDSA. Contro
Page 49 and 50:
Page 51 and 52:
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
Page 57 and 58:
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
Page 63 and 64:
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
Page 71 and 72:
Page 73 and 74:
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
Page 87 and 88:
Laboratories should report positive
Page 89 and 90:
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
Page 99 and 100:
Table 3: FOUR TREATMENT REGIMENS FO
Page 101 and 102:
† 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
Page 109 and 110:
Antituberculosis Drug Rifapentine (
Page 111 and 112:
Reporting Reactions The table below
Page 113 and 114:
Response to Treatment For consultat
Page 115 and 116:
Figure 2: MANAGEMENT OF TREATMENT I
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Post-Treatment Evaluation Routine f
Page 119 and 120:
Treatment in Special Situations Tre
Page 121 and 122:
Resources For consultation regardin
Page 123 and 124:
with an increase in overall complet
Page 125 and 126:
Liver Disease Management of TB in p
Page 127 and 128:
After the initial phase (first two
Page 129 and 130:
Extrapulmonary Tuberculosis The bas
Page 131 and 132:
Page 133 and 134:
Diagnosis of Latent Tuberculosis In
Page 135 and 136:
Forms All required and recommended
Page 137 and 138:
High-Risk Groups Certain factors id
Page 139 and 140:
Diagnosis of Latent Tuberculosis In
Page 141 and 142:
continually exposed to populations
Page 143 and 144:
Administration of the Tuberculin Sk
Page 145 and 146:
See “Two-Step Tuberculin Skin Tes
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See “Live-Virus Vaccines” under
Page 149 and 150:
For more information on IGRAs and t
Page 151 and 152:
Table 5: TARGETED TESTING FOR LATEN
Page 153 and 154:
Page 155 and 156:
Treatment of Latent Tuberculosis In
Page 157 and 158:
Policy Detailed information on the
Page 159 and 160:
Window period prophylaxis is treatm
Page 161 and 162:
Regimens Identify an appropriate re
Page 163 and 164:
Dosages Once the appropriate regime
Page 165 and 166:
Side Effects and Adverse Reactions
Page 167 and 168:
If a patient reports to a healthcar
Page 169 and 170:
Antituberculosis Drug Rifampin (RIF
Page 171 and 172:
DOT is strongly encouraged for thos
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Table 7 describes the duration of t
Page 175 and 176:
Alcoholism Alcohol-Related Treatmen
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Medication Administration and Pharm
Page 179 and 180:
National Tuberculosis Controllers A
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24 CDC . “Recommendations for Use
Page 183 and 184:
Diagnosis and Treatment of Latent T
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All children suspected or diagnosed
Page 187 and 188:
Latent Tuberculosis Infection (LTBI
Page 189 and 190:
History of BCG vaccination is not a
Page 191 and 192:
Because of their higher specificity
Page 193 and 194:
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
Page 201 and 202:
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
Page 215 and 216:
Other TB medications are not commer
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10 Centers for Disease Control and
Page 219 and 220:
Case Management CONTENTS Introducti
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patient-centered approach to case m
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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
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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 and 260:
Medical Orders Progressive Interven
Page 261 and 262:
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
Page 271 and 272:
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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Infectious Period Determine the inf
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In general, for the purposes of con
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General Guidelines for Interviewing
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Healthcare workers should remember
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Index Patient with Positive Acid-Fa
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Index Patient with Negative Acid-Fa
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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
Page 311 and 312:
elease assay; LTBI = latent tubercu
Page 313 and 314:
officials to distinguish between di
Page 315 and 316:
References 1 ATS, CDC, IDSA. Contro
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44 CDC, NTCA. Guidelines for the in
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Page 321 and 322:
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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Page 333 and 334:
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
Page 341 and 342:
Patient Education Materials Get th
Page 343 and 344:
References 1 CDC. Module 4: treatme
Page 345 and 346:
Page 347 and 348:
National Guidelines The following g
Page 349 and 350:
Transfer Notifications CONTENTS Int
Page 351 and 352:
For roles and responsibilities, ref
Page 353 and 354:
Follow-Up Type When to Initiate Not
Page 355 and 356:
Action Transfers Within Alaska Tran
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Provide the patient with a. A copy
Page 359 and 360:
References 1 CDC. International not
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Infection Control CONTENTS Introduc
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of TB infection control principles
Page 365 and 366: Administrative Activities 13 Key ac
Page 367 and 368: Personal Respiratory Protection Alt
Page 369 and 370: For regulations in your area, refer
Page 371 and 372: Employee Health All employees, phys
Page 373 and 374: Figure 1: TWO STEP TESTING AND FOLL
Page 375 and 376: Isolation To reduce disease transmi
Page 377 and 378: Table 4: CRITERIA FOR PATIENTS TO B
Page 379 and 380: When to Initiate Airborne Infection
Page 381 and 382: Confirmed Tuberculosis Disease A pa
Page 383 and 384: Multidrug-Resistant Tuberculosis Di
Page 385 and 386: Environmental Controls in the Patie
Page 387 and 388: Return to Work, School, or Other So
Page 389 and 390: Tuberculosis Infection Control in P
Page 391 and 392: Transportation Vehicles To prevent
Page 393 and 394: 7 CDC. Guidelines for preventing th
Page 395 and 396: Forms: Alaska State Public Health L
Page 397 and 398: ALASKA STATE PUBLIC HEALTH LABORATO
Page 399 and 400: Anchorage Alaska State Public Healt
Page 401 and 402: INDEX CASE INFORMATION Name: DOB: /
Page 403 and 404: CONTACT Name: Tuberculosis Contact
Page 405 and 406: Directly Observed Therapy (DOT) Cal
Page 407 and 408: B. Documents patient care activitie
Page 409 and 410: Alaska TB Program Section of Epidem
Page 411 and 412: Treatment Summary for Active TB Nam
Page 413 and 414: Interjurisdictional Tuberculosis No
Page 415: ! !"#$%&'%()*(+#(,"-./0'1$%+'.,)()/
Page 419 and 420: ! ?"#51)09/02!H0/.!9:(78;7)37028!/'
Page 421 and 422: Latent Tuberculosis Infection (LTBI
Page 423 and 424: Alaska Tuberculosis Program 9210 Va
Page 425 and 426: Instructions for Collecting Sputum
Page 427 and 428: TB Case Management Information Requ
Page 429 and 430: Table 1: First-line anti-tuberculos
Page 431 and 432: Return the fax to the Drug Room (90
Page 433 and 434: Stock Orders: A small supply of
Page 435 and 436: TB/LTBI Medication Return Form Reas
Page 437 and 438: TB/LTBI Stock Medication Request FA
Page 439 and 440: TB Medication Dose Monitoring Regim
Page 441 and 442: TB Medication Dose Monitoring Regim
Page 443 and 444: ALASKA DEPARTMENT OF HEALTH AND SOC
Page 445: Tuberculosis Discharge Planning Che
Page 448 and 449: PART 2: 8. Have you ever been told
Page 450 and 451: Tuberculosis Treatment Contract Dep
Page 452 and 453: Statutes and Regulations Contents I
Page 454 and 455: Regulations Infection Control 7 AAC
Page 456 and 457: place of work is remote from patien
Page 458 and 459: (2) the child or a person acting on
Page 460 and 461: Glossary acid-fast bacilli (AFB): M
Page 462 and 463: eaction size on a later test, which
Page 464 and 465: disseminated TB: See miliary TB. dr
Page 466 and 467:
immunocompromised and immunosuppres
Page 468 and 469:
include medical history and TB symp
Page 470 and 471:
thousands to millions of copies of
Page 472 and 473:
secondary (TB) case: A new case of
Page 474:
eproducing TB organisms from respir
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Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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