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

CDC's Latent Tuberculosis Infection Resources

 This page provides links to updated testing and treatment recommendations for LTBI, other relevant publications, and patient education information.
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.

 

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. 
Screening of Latent TB Infection (LTBI) 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)
Diagnosis of Latent TB Infection (LTBI)

This video describes TB infection and TB disease, discusses testing methods, including IGRAs, and special circumstances and medical evaluation.   (11:05 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.
3HP: Enough "Horse Power" to Drive the National TB Infection Agenda? 3HP is a new strategy for treating latent TB infection. This regimen has been endorsed by the CDC. It is sufficiently new that many clinicians are not familiar with it. This webinar will provide clinicians detailed information about how to use the regimen including monitoring patients for toxicity.
Ask the Expert: Clinical Conundrums in LTBI Treatment 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.
Drug Induced Liver Injury 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 or as printed publication and offers continuing education credits. An accompanying slide set is also available for downloading online. 
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 (LTBI) Mobile App for Health Care Providers

 

 The Latent Tuberculosis Infection Mobile App will be retired September 8, 2017. Updates about future mobile app developments will be posted on the Latent TB Infection Online Hub

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).