2012 TB MANUAL AND PROTOCOLS
2012 TUBERCULOSIS MANUAL
PUBLICATION COVER: Program information and publication date.
TITLE PAGE AND CONTENTS
CHAPTER 1: INTRODUCTION TO MANUAL AND TB CONTROL Including Wyoming laws ans rules regarding TB control, objectives and standards, roles and responsibilities (program staff, consultants, public health agencies, private providers and laboratories).
CHAPTER 2: TB SURVEILLANCE Introduction to surveillance (purpose, policies, laws and rules), TB classification system, how to report TB, data collection forms, registry and document retention, genotyping, dissemination, evaluation.
CHAPTER 3: TARGETED TESTING FOR LATENT TB INFECTION Introduction including the purpose and policies surrounding targetted testing for latent TB, when to do targeted testing, how to increase targeted testing and treatment, screening in facilities.
CHAPTER 4: B NOTIFICATIONS Introduction to notifications including purpose, pre-arrival medical screenings and policies, evaluation and follow-up of B1/B2 TB arrivals (including division of global migration and quarantine forms, patient follow-up, evaluation activities and treatment).
CHAPTER 5: DIAGNOSIS OF TB DISEASE Purpose, policy and forms for the diagnosis of TB disease, identification and follow-up ofsuspected TB cases, diagnosis of TB disease including medical history review, HIV screening, physicial examinations, TB skin test and IGRA testing, radiography and bacteriologic examinations.
CHAPTER 6: TREATMENT OF TB DISEASE Purpose, policy and forms for the treatment of TB disease, basic treatment principles, regimens, dosages and durations of treatment, side effects and adverse reactions (monitoring, reporting), response to treatment, completion of therapy, post-treatment evaluation, treatments in special situations (including drug-resistant TB, HIV infection, alcohol use, liver disease, renal insufficiency and end-stage renal disease, TB associated with tumor necrosis facto-alpha antagonists, culture-negative pulmonary TB, extrapulmonary TB, pregnancy and breastfeeding, TB in children).
CHAPTER 7: DIAGNOSIS OF LATENT TB INFECTION Purpose, policy and forms for diagnosis of latent TB infection, high-risk groups, diagnosis through interferon gamma release assays (IGRA) and Mantoux TB skin testing, candidates for mantoux TB skin testing, administration/ measurement/ interpretation of the TB skin test, HIV screening, follow-up activities and chest radiography.
CHAPTER 8: TREATMENT OF LATENT TB INFECTION Introduction, whom to treat (susceptible/ vunlerable contacts, TB skin test results of 5mm/ 10mm/ 15mm or more, treatment regimens and dosages, side effects and adverse reactions (monitoring and reporting). Adherence to treatment (monthly assessment and directly observed therapy), completion of therapy and special situations (including HIV/ Latent TB infection, alcohol use, pregnancy, breastfeeding.
CHAPTER 9: CASE MANAGEMENT Introduction (including purpose, policy, forms, acknowledgments), initial assessment (cultural sensitivity, language issues, patient’s medical records, assessment site, discharge planning, intial assessment activities), treatment plan components, activities and implementation. Ongoing assessment activites, monitoring for side effects/ adverse reactions/ bacterial/ and clinical improvements. Verifying completion of therapy, adequate course of treatment, calculating completion of therapy and closures other than completion. Evaluation activities, directly observed therapy (candidates, how to deliver, adherence to), incentives and enablers (eligible patients, available incentives), procgressive interventions, types of legal orders and how to process them.
CHAPTER 10: CONTACT INVESTIGATION Introduction, basic steps and planning for contact investigation, factors prediciting transmission and the decision to initiate contact investigation, index patient and transmission site information, contact evaluation and treatment, ongoing management activites and time frame of contact investigation activities. Infection period, index patient pre-interview preparation and general guidelines. Field investigation, contact priorities, evaluation, treatment and follow-up. When to expand contact investigation and low-priority contacts. Data management and evaluation of contact investigations, outbreak investigations and Wyoming TB outbreak response plan.
CHAPTER 11: LABORATORY SERVICES Introduction, available lab tests, specimen collection and shipment.
CHAPTER 12: PATIENT EDUCATION Introduction, general guidelines, language and comprehention barriers, education topics (diagnosis, contact investigation, isolation, side effects, adverse reactions, adherence), patient education materials.
CHAPTER 13: CONFIDENTIALITY Introduction, CDC guidance on HIPAA, Wyoming HIPAA policies, national confidentiality guidelines.
CHAPTER 14: TRANSFER NOTIFICATIONS Introduction, when and how to initiate/ issue a notification (both within and outside of the United States),
CHAPTER 15: SUPPLIES, MATERIALS, AND SERVICES Introduction, Mantoux TB skin testing supplies, Interveron Gamma Release Assay supplies, chest radiographs, specimen collection and shipment supplies, anti-tuberculosis medications, incentives and enablers, medical interpretation services, healthcare staff training and education.
CHAPTER 16: INFECTION CONTROL Introduction, Infection Control Measures (Administrative, Environmental, Personal respiratory protection), two-step TB skin testing, estimating infectiosness and determining non-infectiousness, airborne infection isolation,hospital discharge determinations, residential setting infection control measures, social settings (school, work, other), TB infection control in patient care facilities and transportation vehicles (self-treansport, healthcare workers, emergency medical services).
CHAPTER 17: GLOSSARY
WYOMING TB PROTOCOLS
WY TB Outbreak Response Plan