For Health Departments and TB Programs

imageAs both the healthcare landscape and the epidemiology of TB in the US shift, community providers will play an increasingly important role in screening, diagnosis and treatment of TB infection and potential early identification of patients with TB disease.  Since patients at higher risk for TB infection and disease, including those who are recent arrivals in the United States may present more frequently in these settings, building relationships with FQHCs in your area can have a positive impact on overall TB control.  Conducting this type of screening and treatment of LTBI at the community level can be a benefit to health departments and TB programs with limited resources and also may be more convenient for patients.

This toolkit includes various resources, training materials and templates that may be used to reach out to community providers in your area, with a focus on materials around screening, diagnosis and treatment of TB infection.  Many of the materials below may be useful to send or bring to FQHCs, either as part of an educational outreach effort, or if a case has been diagnosed within a particular setting.  Most of the materials identified below have been developed with the busy clinician in mind, and are quick resources or references geared to increase the knowledge and skill of community providers in the diagnosis and treatment of LTBI.

Background Material
Description and Use
HRSA Website  
Background on HRSA supported health centers
List of Primary Care Associations for each state
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.
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.  This can be shared with leadership at FQHCs as a potential self-directed training opportunity for their staff.

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).
Latent TB Infection Multimedia Videos This set of three brief multimedia videos from the Global Tuberculosis Institute covers the screening, diagnosis and treatment of LTBI.   The videos are targeted to community health providers and range in length from 5-15 minutes. They can be emailed to FQHC staff 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. (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)

Archived webinars The TB COEs have a wide range of archived webinars available. The webinars below may be of particular interest or utility to providers at FQHCs. The links to the webinars can be provided to staff at FQHCs for self-directed learning for individuals, or for group viewing and discussion.
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.
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 and children, and pregnant women. Continuing education credits are available for this course.