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Tuberculosis Prevention and Control Internship

TB BACKGROUND

Fever

Persistent cough (3 weeks)

Weight loss

Lymphaden-opathy(LAD)

Fatigue

Night Sweats

Chest Pain

Hemoptysis

Chills

DATA AND STATISTIC

Symptoms of TB

RESULTS

TB Testing Methods

METHODS

Phase I- Project Research & Writing

Transmission and PathogenesisPhase II- Project Evaluation and

Analysis

METHODS CONTINUED

The Need for a TB Desk-Guide for School Nurses

Lack of official TB literature targeted towards school nurses and school based health care providers

Unclear understanding of TST reading & interpretation, and Direct Observed Therapy (DOT) forms instructions

RECOMMENDATIONS

TB blood tests

Interferon-gamma release assays or IGRAs- measures how the immune

system reacts to the bacteria that cause

TB.

Two IGRAs are approved by the

U.S. Food and Drug Administration (FDA) and are

available in the United States

QuantiFERON®–TB Gold In-Tube test

(QFT-GIT)

T-SPOT®.TB test (T-Spot)

County C#

Harris 320

Dallas 167

Bexar 89

Tarrant 77

Hidalgo 70

Cameron 67

El Paso 43

Travis 49

Collin 27

Webb 25

The 3-year average rate of tuberculosis greater than 2

times higher than the average for Texas

Brooks Calhoun Cameron Cherokee

Collingsworth Edwards Frio Garza

Hansford Jack La Salle Lipscomb

Martin Moore Nacogdoches Parmer

Reagan Terry Val Verde Webb

Zavala

Tuberculosis is caused by the

Mycobacterium tuberculosis and

is spread by airborne droplet

nuclei

The transmission of TB is caused by prolonged contact with the infected

individual.

Transmission occurs by coughing,

sneezing, laughing or singing.

Any person with active pulmonary

TB disease can infect an

estimated 10-14 people in a year

TB Skin Testing

The diagnostic tool for detection of TB

infection is the tuberculin skin test

(TST) using the Mantoux method.

“Target testing” is recommended, and

Routine testing should not be done in low prevalence

areas

As the school nurse, you may be asked to do the testing for a

“high-risk child”

Literature research on educational TB resources

Annotation of the previously written material for the project.

Proposed modifications to the DSHS and submitted work plan for

approval

Initiate and complete writing phase

References and appendix

Submit for review to DSHS Supervisor

Create an anonymous feedback survey and administer to a sample of school nurses.

Gather the survey results and discuss feedback

Finalize the document.

Submission to DSHS for publication and usage as a future

resource

Officially publish the desk- guide under as a DSHS

resource

Distribution of the guide to all

the school nurses and

school campus DOT providers

Continued Training and CE

for school nurses on TB related

topics

By: Marym Lakhani- MPH, BSc. Des Moines University- College of Health SciencesTexas Department of State Health Services & TB elimination Division, Region 4/5N

Health Service Region

Number of Cases

Percentage of Cases (%)

1 52 4.09

2/3 305 24.03

4/5N 43 3.38

6/5S 387 30.5

7 82 6.46

8 132 10.4

9/10 56 4.41

11 189 14.9

Texas 1269 100

100% of the respondees found it to be a helpful addition

to TB training & related educational

materials.

For 100% of the respondees, it took less than an hour to

read

100% of the respondees indicated

that the guide addressed all the

relevant TB related topics for school

nurses

100% of the respondees indicated

the guide provides detailed instructions on Direct Observed Therapy (DOT) with

visual aids

67% of the respondees found the guide “easy to

read” whereas 33% found the guide “very easy to read”