Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

Initial assessment activities ................................ 10.8
Treatment Plan .................................... 10.14
Treatment plan components ............................ 10.15
Planning activities ............................................ 10.15
Implementation activities .................................. 10.17
Ordering TB medications ................................. 10.18
Ongoing Assessment
and Monitoring .................................... 10.20
Ongoing assessment activities ........................ 10.20
Monitoring side effects and
adverse reactions ............................................. 10.24
Activities to monitor for side effects and
adverse reactions ............................................. 10.24
Monitoring bacteriologic improvement ............. 10.25
Activities to monitor for bacteriologic and
clinical improvement ........................................ 10.25
Completion of Therapy ...................... 10.29
Verifying adequate course of treatment ........... 10.29
Calculating completion of therapy .................... 10.29
Documenting completion of treatment and
follow-up recommendations ............................. 10.30
Closures other than completion of therapy ...... 10.31
Evaluation ............................................ 10.32
Evaluation activities ......................................... 10.32
Directly Observed Therapy ................ 10.34
Candidates for directly observed therapy ........ 10.34
How to deliver directly observed therapy ......... 10.35
DOT Aides, regimens and payment for DOT ... 10.35
Adherence to directly observed therapy .......... 10.38
Incentives and Enablers .................... 10.40
Medical Orders .................................... 10.41
Progressive interventions ................................. 10.41
Resources and References ............... 10.42
CONTACT INVESTIGATION
Introduction ........................................... 11.2
Purpose.............................................................. 11.2
Policy ................................................................. 11.3
Forms ................................................................ 11.4
Structure of a
Contact Investigation ........................... 11.5
Basic steps of a contact investigation ............... 11.5
Contact investigation plan ................................. 11.5
Decision to Initiate a
Contact Investigation ........................... 11.6
Factors predicting transmission
of tuberculosis ................................................... 11.6
Deciding to initiate a contact investigation ........ 11.8
Time Frames for
Contact Investigation ......................... 11.12
Information about the index patient
and transmission sites ..................................... 11.12
Contact evaluation and treatment ................... 11.15
Ongoing management activities ...................... 11.17
Infectious Period ................................. 11.20
Index Patient Interviews ..................... 11.23
Preinterview preparation ................................. 11.23
General guidelines for interviewing
an index patient ............................................... 11.24
Field Investigation .............................. 11.25
Contact Priorities ................................ 11.27
Index patient with positive acid-fast bacilli
sputum smear results
or cavitary tuberculosis.................................... 11.28
Index patient with negative acid-fast bacilli
sputum smear results ...................................... 11.30
Index patient with negative bacteriologic
results and abnormal chest radiographs
not consistent with tuberculosis....................... 11.31
Contact Evaluation, Treatment, and
Follow-up ............................................. 11.32
Immunocompromised contacts
and children under five .................................... 11.33
Immunocompetent adults and
children five and older
(high- and medium-priority contacts) ............... 11.35
Contacts with prior positive
tuberculin skin tests ........................................ 11.36
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 V
Revised November 2012