Alaska Tuberculosis Program Manual - Epidemiology

Alaska Tuberculosis Program Manual Alaska Department of Health and Social Services November, 2012

Page 2 and 3: Table of Contents INTRODUCTION Abou
Page 4 and 5: Liver disease .....................
Page 6 and 7: Initial assessment activities .....
Page 8 and 9: INFECTION CONTROL Introduction ....
Page 10 and 11: About the Alaska Tuberculosis Progr
Page 12 and 13: Bookmarks In PDF files, you can use
Page 14 and 15: Icons Throughout the manual, these
Page 16 and 17: FDA U.S. Food and Drug Administrati
Page 18 and 19: Purpose of Tuberculosis Control Tub
Page 20 and 21: Objectives and Standards Quality of
Page 22 and 23: Indicator 2 TB case rate Decline in
Page 24 and 25: Indicator 4 Timely laboratory repor
Page 26 and 27: Roles, Responsibilities, and Contac
Page 28 and 29: Roles and Responsibilities Contact
Page 30 and 31: TABLE 5: Roles, Responsibilities, a
Page 32 and 33: Surveillance CONTENTS Introduction
Page 34 and 35: In addition to providing the epidem
Page 36 and 37: Policy Data collection and reportin
Page 38 and 39: Table 1: CASE DEFINITIONS 12 Clinic
Page 40 and 41: Reporting Suspected or Confirmed Ca
Page 42 and 43: Laboratories Laboratories should re
Page 44 and 45: Chest radiograph results Drug regi
Page 46 and 47: Dissemination and Evaluation Dissem
Page 48 and 49: Targeted Testing for Latent Tubercu
Page 50 and 51: For roles and responsibilities, ref
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Table 1: Persons at High Risk for T
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The other approach is to establish
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References 1 ATS, CDC, IDSA. Contro
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Introduction Purpose Use this secti
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Overseas Screening of Applicants fo
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Policy Newly arrived refugees and i
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Patient Follow-up The immigration p
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Table 4: EVALUATION AND FOLLOW-UP R
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Resources and References Resources
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Diagnosis of Tuberculosis Disease C
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A diagnosis of TB disease is usuall
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High-Risk Groups Certain factors id
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Case Finding Identifying Suspected
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Follow-up on Suspected Cases of Tub
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Table 4: GUIDELINES FOR THE EVALUAT
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Source: Adapted from: ATS, CDC, IDS
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examination, chest radiograph, bact
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Refer to Table 7 below for informat
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Resources and References Resources
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settings, 2005. MMWR 2005;54(No. RR
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Treatment of Tuberculosis Disease C
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State Laws and Regulations AS 18.15
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Phase Principles Persistent Positiv
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number (1, 2, 3, or 4), and the opt
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Dosages Once the appropriate regime
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Duration of Treatment Use the treat
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Side Effects and Adverse Reactions
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Table 5: MONITORING AND INTERVENTIO
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Antituberculosis Drug Rifabutin (RF
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Antituberculosis Drug Ethambutol (E
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Monitoring for Side Effects and Adv
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Completion of Therapy A full course
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Case Closing and End-of-Treatment E
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For consultation regarding post-tre
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Acquired drug resistance usually de
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use and retention, if at all possib
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Figure 3: RESTARTING ANTI-TB MEDICA
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Tuberculosis Associated with Tumor
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Figure 4: TREATMENT ALGORITHM FOR A
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Pyridoxine supplementation (25 mg/d
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24 ATS, CDC, IDSA. Treatment of tub
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Introduction Purpose Use this secti
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Tuberculosis Classification System
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Table 2: PERSONS AT HIGH RISK FOR T
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In Alaska, because of our historic
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Use the Tuberculosis Screening Ques
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How to Administer a Tuberculin Skin
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How to Interpret a Tuberculin Skin
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Interferon Gamma Release Assays Int
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Authorize chest radiographs for pat
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Work or School Clearance Persons wi
See Also
Municipality of Anchorage Tuberculosis, a disease that devastated Alaska in the past, took a big jump in 2022 Statutes and Regulations ALASKA DEPARTMENT OF HEAL
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14 CDC. Epidemiology and Prevention
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Introduction Purpose Use this secti
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Whom to Treat Determine whom to tre
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Treatment Regimens and Dosages Sele
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New 12-week Isoniazid-Rifapentine r
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The use of INH elixir is discourage
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3. Reporting Reactions to Antituber
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Table 6: MONITORING AND INTERVENTIO
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Adherence Monitor patients for adhe
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Completion of Therapy Determine whe
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Treatment in Special Situations Hum
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isk relapse, development of drug-re
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Resources and References Resources
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References 1 CDC. Treatment of late
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53 CDC. Approaches to improving adh
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Introduction Purpose Use this secti
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Primary TB infection is usually acc
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Tuberculin Skin Test Recommendation
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The interpretation of TST results i
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All children with a positive TST sh
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Management of Children with a Posit
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LTBI Treatment Regimens Table 4 REC
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Dosages for LTBI Treatment Regimens
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Pyridoxine (Vitamin B6): Routine ad
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Tuberculosis Disease Diagnosis of T
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Radiologic abnormalities in childre
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Otherwise, ethambutol is always inc
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First-Line TB Drugs The first-line
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Pharmacology and Adverse Reactions
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The recommended dose is 6.25 mg (1/
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Drug Delivery Options Appendix A. 4
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Resources and References Resources
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41 Donald PR, Maher D, Maritz JS, e
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Introduction Purpose Tuberculosis (
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Forms Required and recommended form
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Initial Assessment Conduct initial
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Whenever possible, start the initia
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case report, a tuberculin skin test
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Directly observed therapy (DOT) is
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Treatment Plan When sufficient info
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Establish the treatment plan, ensur
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necessary to coordinate the arrange
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Ongoing Assessment and Monitoring C
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Ensure that medications are ordered
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Monitoring Side Effects and Adverse
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een documented from different days.
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3. Progressive improvement in the c
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Use the TB Medication Dose Monitori
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Evaluation Evaluate case management
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Directly Observed Therapy Provide d
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DOT Regimens The Alaska TB Program
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a. Provide patient education b. Hel
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Incentives and Enablers Use incenti
See Also
Directly Observed Therapy
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Resources and References General Ca
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Institute Web site]. (no year):9. A
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54 California Department of Health
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Contact Investigation CONTENTS Intr
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Except in rare cases, every case of
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Structure of a Contact Investigatio
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positive. 15 The significance of re
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Figure 1: DECISION TO INITIATE A CO
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For more information on outbreak in
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Table 2: TIME FRAMES FOR INVESTIGAT
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Contact Evaluation and Treatment In
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Ongoing Management Activities Ongoi
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Source: Adapted from: California De
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Table 5: GUIDE FOR ESTIMATING THE B
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Index Patient Interviews Conduct in
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Field Investigation A field investi
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Contact Priorities Assign prioritie
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* HIV or other medical risk factor.
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Index Patient with Negative Bacteri
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Immunocompromised Contacts and Chil
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Immunocompetent Adults and Children
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Figure 6: EVALUATION, TREATMENT, AN
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Sometimes the result from an invest
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Data Management and Evaluation of C
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Index Patient and Contact Data Use
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Table 8: DATA ABOUT EACH CONTACT 58
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Outbreak Investigation If data from
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Resources and References Resources
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23 CDC, NTCA. Guidelines for the in
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Laboratory Services CONTENTS Introd
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Laboratory Contact Information To l
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Laboratories should report positive
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Specimen Collection Sputum is phleg
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Table 5: SPECIMEN COLLECTION METHOD
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How to Collect Gastric Aspirates Th
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For more information, contact ASPHL
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US Department of Transportation. Ha
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Introduction Purpose Use this secti
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General Guidelines Table 1: GUIDELI
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For assistance with language issues
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2. Explain the common side effects
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Resources and References Resources
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Confidentiality CONTENTS Introducti
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Health Insurance Portability and Ac
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Resources and References Resources
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Introduction Purpose Use this secti
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When to Initiate a Notification For
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How to Issue a Notification How a n
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Transfers Outside the United States
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3. Provide the patient with a. the
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SUPPLIES AND SERVICES PROVIDED BY T
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Introduction Purpose Use this secti
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Hierarchy of Infection Control Meas
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Environmental Controls TB is caused
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In addition, training topics should
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Who Should Use a Mask or Respirator
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Table 3: FOUR APPOINTMENT SCHEDULE
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Screening for persons with previous
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Estimating Infectiousness In genera
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Airborne Infection Isolation in a H
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When to Discontinue Airborne Infect
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Hospital Discharge The decisions to
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Residential Settings Patients suspe
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Other Residential Settings Motels H
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Multidrug-Resistant Tuberculosis (M
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Table 13: GUIDELINES FOR TUBERCULOS
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Resources and References Resources
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38 ATS, CDC, IDSA. Controlling tube
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TB/LTBI Prescription and Medication
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Alaska TB Program: Timeline for the
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Consent for Release of Medical Info
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*Figure 1: Contact Priorities: High
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Instructions for Completing Tubercu
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I. Overview Directly Observed Thera
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MEMORANDUM OF AGREEMENT between Dir
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Date: Name Address Dear Department
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Confidential Infectious Disease Rep
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Date Notification Received / / Retu
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Liver Function Flowsheet Patient Na
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Instructions for Completing Latent
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Department of Health and Social Ser
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TB Case Management Form Client Name
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ALASKA DHSS, DPH, TB PROGRAM TB/LTB
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TB/LTBI Prescription and Medication
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Caution Labels: Appropriate cautio
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All medication storage areas should
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How to use the TB/LTBI Medication R
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How to use the TB/LTBI Stock TB Med
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TB Medication Dose Monitoring Regim
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TB Medication Dose Monitoring Regim
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ALASKA DEPARTMENT OF HEALTH AND SOC
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Alaska Tuberculosis Program TUBERCU
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Tuberculosis Screening Questionnair
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The Alaska TB Program and my PHN Ca
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Introduction Purpose Use this secti
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(3) employee does not handle clinic
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School Screening 7 AAC 27.213. Tube
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Resources and References Conditions
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confirmed infectious TB disease. En
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contact investigation: Procedures t
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extrapulmonary TB: TB disease in an
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advancing infection (e.g., shadows
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Another term for NTM is mycobacteri
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adiography: The diagnostic imaging
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suspected TB: A tentative diagnosis

Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska (2024)

References