Level Setting Activity_Provider

Final – 05/06/20

PROVIDER LEVEL SETTING MATERIAL

Moderator to show a document on the screen with the information below. The moderator will show the document on the screen and allow respondents read it to themselves and ask about probe about any questions or confusion among participants to ensure a baseline level of knowledge. Moderator has the ability to show the document again, if participants need to reference this document during the discussion.

+++

The Centers for Disease Control and Prevention (CDC) is the leading national public health agency of the United States, and is a part of the Department of Health and Human Services.

CDC’s Guidelines on TB Testing: Certain people should be tested for TB infection because they are at an increased risk for being TB infection, including:

• People born in or who frequently travel to countries where TB disease is common, including Mexico, the Philippines, Vietnam, India, China, Haiti, and Guatemala, or countries with high rates of TB.

• People who currently, or used to, live in large group settings, such as homeless shelters or prisons and jails where TB is more common.

• Health care workers and other who work in places at high risk for TB transmission, such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV

• Someone who has spent time with a person who has infectious TB disease

• Others with weakened immune systems, such as those with certain health conditions or taking certain medications. This includes individuals with HIV, substance abuse, silicosis, Diabetes mellitus, severe kidney disease, low body weight or head and neck cancer; or individuals who have had medical treatments such as corticosteroids or organ transplant or specialized treatments for rheumatoid arthritis or Crohn’s disease

• Children, especially those under age 5, if they are in one of the risk groups noted above

There are two kinds of tests that are used to determine if a person has been infected with TB bacteria: the TB blood test (IGRA – short for interferon gamma release assay), and the tuberculin skin test (TST), which is also known as the PPD test.

The TB blood test (IGRA) is the preferred method of TB infection testing for the following:

• People who have received the Bacille Calmette-Guérin (BCG) vaccine

• People who have a difficult time returning for a second appointment to look at the TST after the test was given

CDC’s Guidelines on Treating LTBI: There are four treatment regimens available for the treatment of latent TB infection (LTBI).

While all the regimens are effective, health care providers should prescribe shorter regimens when possible. Patients are more likely to complete shorter treatment regimens.