Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
State Laws and Regulations AS 18.15.380. Medical treatment By statute, health care providers who examine or treat individuals who may have contagious diseases should instruct individuals about preventing transmission and the need for treatment. The Alaska Department of Health and Social Services may administer treatment, including DOT to consenting individuals who have or may have been exposed to an infectious disease. Individuals may refuse treatment if they are willing to follow the recommendations of the state medical officer to prevent the spread of a communicable disease to others. See the Statutes and Regulations section of this manual (19.1) or Conditions Reportable to Public Health, pages 19-40, available at: http://www.epi.hss.state.ak.us/pubs/conditions/ConditionsReportable.pdf Program Standards Persons with newly diagnosed TB, for whom therapy for 1 year is indicated, will complete therapy within 12 months. Persons with newly diagnosed pulmonary TB will receive an ATS/IDSA/CDC* recommended treatment regimen. 2 All persons with pulmonary tuberculosis will receive treatment using directly observed therapy (DOT). *ATS – American Thoracic Society; IDSA – Infectious Disease Society of America; CDC – Centers for Disease Control and Prevention Forms See Conditions Reportable to Public Health for forms and instructions on how to report suspected or confirmed cases of tuberculosis in Alaska. It is available at: http://www.epi.hss.state.ak.us/pubs/conditions/ConditionsReportable.pdf For roles and responsibilities, refer to the “Roles, Responsibilities, and Contact Information” topic in the Introduction 1.18. 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 Treatment of Tuber culosis Disease 6.3 Revised November 2012
Basic Treatment Principles Follow the basic treatment principles for tuberculosis (TB) disease, as outlined below in Table 1. Table 1: BASIC TREATMENT PRINCIPLES FOR TUBERCULOSIS DISEASE Phase Principles At Start of Treatment Regimen During Treatment Patient-centered care and directly observed therapy (DOT). An adherence plan should tailor treatment and supervision to each patient by considering his or her clinical and social circumstances (patient-centered care), as well as emphasizing DOT. Cultural competence. It is imperative to become culturally competent and guide other healthcare providers toward culturally competent healthcare. A culturally competent system acknowledges cultural differences regarding healthcare and incorporates them into all levels of the healthcare delivery system, from policy to provider to patient. Human immunodeficiency virus (HIV) testing. HIV testing should be offered to all patients with TB disease. Medical supervision. Patients with confirmed or suspected tuberculosis (TB) disease must be under the medical supervision of a health care provider who is licensed in the State of Alaska. Prompt start. Start patients with confirmed or suspected TB disease promptly on appropriate treatment. It is not necessary to wait for laboratory confirmation. Multiple drugs. Treatment regimens must contain multiple drugs to which the organism is susceptible. The administration of a single drug or the addition of a single drug to a failing regimen can lead to the development of resistance. Single doses. TB medications should be administered together as a single dose rather than in divided doses. A single dose leads to higher, and potentially more effective, peak serum concentrations, and facilitates DOT. Although ingesting the medications with food will delay or moderately decrease the absorption of the medications, the effects are of little clinical significance. Pyridoxine to prevent neuropathy. Pyridoxine (Vitamin B-6, 25 mg) is recommended for some individuals receiving isoniazid (INH) as part of their treatment regimen to prevent peripheral neuropathy. It should be used in persons at risk for neuropathy (women who are pregnant or breastfeeding or persons with nutritional deficiency, diabetes, HIV infection, renal failure, or alcoholism). 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 Treatment of Tuber culosis Disease 6.4 Revised November 2012
- Page 43 and 44: Data Collection Forms The following
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- Page 47 and 48: References 1 ATS, CDC, IDSA. Contro
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<strong>State</strong> Laws and Regulations<br />
AS 18.15.380. Medical treatment<br />
By statute, health care providers who examine or treat individuals who may have<br />
contagious diseases should instruct individuals about preventing transmission and the<br />
need for treatment. The <strong>Alaska</strong> Department <strong>of</strong> Health and Social Services may<br />
administer treatment, including DOT to consenting individuals who have or may have<br />
been exposed to an infectious disease. Individuals may refuse treatment if they are<br />
willing to follow the recommendations <strong>of</strong> the state medical <strong>of</strong>ficer to prevent the spread<br />
<strong>of</strong> a communicable disease to others.<br />
See the Statutes and Regulations section <strong>of</strong> this manual (19.1) or<br />
Conditions Reportable to Public Health, pages 19-40, available at:<br />
http://www.epi.hss.state.ak.us/pubs/conditions/ConditionsReportable.pdf<br />
<strong>Program</strong> Standards<br />
Persons with newly diagnosed TB, for whom therapy for 1 year is<br />
indicated, will complete therapy within 12 months.<br />
Persons with newly diagnosed pulmonary TB will receive an ATS/IDSA/CDC*<br />
recommended treatment regimen. 2<br />
All persons with pulmonary tuberculosis will receive treatment using directly<br />
observed therapy (DOT).<br />
*ATS – American Thoracic Society; IDSA – Infectious Disease Society <strong>of</strong> America; CDC – Centers for Disease Control<br />
and Prevention<br />
Forms<br />
See Conditions Reportable to Public Health for forms and instructions on<br />
how to report suspected or confirmed cases <strong>of</strong> tuberculosis in <strong>Alaska</strong>. It is<br />
available at:<br />
http://www.epi.hss.state.ak.us/pubs/conditions/ConditionsReportable.pdf<br />
For roles and responsibilities, refer to the “Roles, Responsibilities, and<br />
Contact Information” topic in the Introduction 1.18.<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 Treatment <strong>of</strong> Tuber culosis Disease 6.3<br />
Revised November 2012
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