For Community Health Centers and Federally Qualified Heath Centers

 

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Clinicians in the community, including at CHC and FQHCs have a unique opportunity to identify those at risk for latent TB infection (LTBI) and TB disease. Understanding who is at risk for TB, screening appropriately, diagnosing and treating TB infection and maintaining a high index of suspicion for TB disease in high risk populations can have significant impacts, both for individual patients and from a public health perspective.

The tools below can help you and your colleagues in these settings get updated information on TB, including information on new diagnostic tests and treatment regimens.  Many of these resources are specifically developed for busy clinicians and can be easily accessed and utilized in a variety of formats.

Background Materials

Background Material
Description and Use
Contact List for  US  TB Control Programs Knowing the key TB control staff in your state or city can be very helpful for obtaining local policy and guidelines, answering questions, and accessing TB medical consultation or other available resources.  This list from National TB Controllers Association (NTCA) provides contact information for TB controllers and other key staff including nurse consultants.
CDC Slide Sets These slides sets can be used for providing brief educational presentations on TB for staff at your FQHC. You could also call on your state or local health department for education and training needs.
CDC TB Guidelines This page includes link for all current CDC guidelines which are listed by topic and date.

Trainings

Trainings
Description and Use
TB 101 for Health Care Workers This brief web-based course from CDC and the TB RTMCCs is designed to educate health care workers about basic concepts related to TB prevention and control in the United States.  Continuing education credits are available for this course, which takes about one hour to complete.
LTBI Multimedia Videos This set of three brief multimedia videos from the Global Tuberculosis Institute covers the screening, diagnosis and treatment of LTBI.  These mobile-friendly multimedia videos are targeted to community health providers, and range in length from 5-15 minutes and the link can be easily forwarded to others. 
This video discusses screening for LTBI and covers targeting testing, high risk groups and testing methods including interferon gamma release assays (IGRAs) (6:35 minutes)

This video describes TB infection and TB disease, discusses testing methods, including IGRAs, and special circumstances and medical evaluation.   (11:05 minutes)

This video discusses treatment regimens, including the new 12-dose regimen, recent guidelines, special circumstances, adverse effects and adherence.   (15:09 minutes)

Archived webinars

The TB Regional Training and Medical Consultation Centers have a wide range of archived webinars available. The webinars below may be of particular interest or utility for providers at FQHCs. The webinars can be viewed individually or viewed and discussed in a group setting such as a meeting or training.
This archived 90-minute webinar from the Curry International TB Center is geared to physicians and other licensed medical professionals who diagnose and treat LTBI. The webinar focuses on risk assessment, diagnosis, and treatment options for LTBI.  
This archived 2-hour “Grand Rounds” webinar from the Southeastern National TB Center examines “lessons learned” from a “practical” standpoint and shares experiences for enhancing the utilization of Interferon Gamma Release Assays (IGRAs) for the diagnosis of LTBI in different clinical situations.
This archived 2-hour webinar from the Curry International TB Center covered some common questions around LTBI treatment that may not be addressed in national guidelines, but represent a sample of everyday challenges shared by providers of LTBI care.
This 60-minute webinar from the Curry International TB Center for was developed for public and private clinicians and allied health personnel who work with tuberculosis (TB). It presents key information that providers need to know when working with patients with compromised liver function due to taking TB medication.
Core Curriculum on Tuberculosis: What the Clinician Should Know

The CDC’s Core Curriculum is intended for use as a self-study guide and reference manual for clinicians and other public health professionals caring for people with or at high-risk for TB infection or disease. It is available online for download, as an interactive course or as printed publication and offers continuing education credits. An accompanying slide set is also available for downloading.

Treating LTBI In Special Situations This self-paced online course from the Southeastern National TB Center consists of interactive case-based modules focusing on treatment for LTBI in special situations, many of which may be encountered in FQHCs. These include patients with HIV/AIDS, hepatitis infants & children, and pregnant women. Continuing education credits are available for this course.

Resources and Reference Materials

Resources and Reference Materials
Description and Use
Latent TB Infection: A Guide for Primary Health Care Providers This brief CDC booklet (25 pages without appendices) coves the basics of LTBI, and can be viewed online. Printed copies can be ordered from the CDC website, and are very useful as a quick reference tool.
Latent TB Infection (LTBI) Mobile App for Health Care Providers This app from CDC is based on the Guide for Primary Care Providers and is available for Androids and Apple devices

Management of LTBI in Children and Adolescents: A Guide for the Primary Care Providers

This brief booklet from the Global Tuberculosis Institute is a resource for primary care providers. Topics include targeted testing, risk assessment, and treatment of LTBI in children and adolescents based on recommendations from the American Academy of Pediatrics Report of the Committee on Infectious Diseases (Red Book).
Diagnosis and Treatment of Latent TB Infection Pocket Card

GTBI’s laminated pocket-sized card for clinicians provides information on diagnosis of latent tuberculosis infection and recommendations for current treatment regimens.

California TB Risk Assessment Tool and Factsheet

These resources, jointly developed by the Tuberculosis Control Branch at the California Department of Public Health, the California Tuberculosis Controllers Association and the Curry International Tuberculosis Center, are designed to help busy clinicians quickly and easily identify adults who are at high-risk for TB exposure or progression to TB disease and therefore should be tested for LTBI.

CDC Factsheets These 1 page factsheets for providers are useful references and can either be printed or viewed electronically.
 

 

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