Welcome to the training on Guidelines for Tuberculosis Screening, Testing and Treatment provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this tutorial is to equip Texas Health Steps providers and others to employ best practices for tuberculosis (TB) screening, testing, and treatment in children and adolescents.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Complete TB risk assessment as part of pediatric checkups and follow up with TB testing when indicated.
- Determine which TB screening test is preferred based on a child’s age and risk factors.
- Apply the recommended treatment regimen for children and adolescents with TB infection, formerly known as latent TB infection (LTBI).
Please note this module expires on 8/15/2022.
This module was released on 8/15/2019.
Accreditation Statement
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 0.75 contact hour(s) of Continuing Nursing Education.
Social Workers
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 0.75 contact hour(s) of Continuing Social Work Education.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 0.75 hour(s) for attendance.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
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- American Thoracic Society, Centers for Disease Control and Prevention, & Infectious Diseases Society of America. (2016). Executive Summary: Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. (2016). Clinical Infectious Diseases, 63(7), 853–867.
- Centers for Disease Control and Prevention. (2018). Update of Recommendations for Use of Once-Weekly Isoniazid-Rifapentine Regimen to Treat Latent Mycobacterium tuberculosis Infection.
- Morbidity and Mortality Weekly Report, (MMWR), 67(25), 723-726.
- Centers for Disease Control and Prevention. (2010). Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium tuberculosis Infection. Morbidity and Mortality Weekly Report (MMWR), 59(RR05), 1-25.
- Heartland National Tuberculosis Center. (2019) The University of Texas Health Science Center at Tyler.
- Texas Health and Human Services, Texas Department of State Health Services. (2019). Infectious Disease Control Unit: Tuberculosis.
- Texas Health and Human Services, Texas Department of State Health Services. (2018). Texas Tuberculosis Work Plan. Tuberculosis and Hansen’s Disease Branch.
- Texas Health Steps, Child Health Clinical Record Forms.
- Texas Health Steps, Periodicity Schedule.
- Texas Health Steps, TB Screening Questionnaire.
- Texas Medicaid & Healthcare Partnership. Texas Medicaid Provider Procedures Manual.
- University of Rochester Medical Center. (2019). Health Encyclopedia: Tuberculosis (TB) in Children.
- Centers for Disease Control and Prevention brochure. TB: Protect Your Family and Friends from Tuberculosis: The TB Contact Investigation.
- Centers for Disease Control and Prevention fact sheets. Tuberculosis: General Information.
- KidsHealth from Nemours. For Parents: Tuberculosis.
- Texas Health and Human Services, Texas Department of State Health Services. TB Information for Patients and Family Members
- U.S. Department of Health and Human Services, Head Start Early Childhood Learning & Knowledge Center. What Parents Should Know About Tuberculosis.
Centers for Disease Control and Prevention. (2019). Cost-effectiveness of Latent Tuberculosis Infection Screening before Immigration to Low-Incidence Countries. Emerging Infectious Diseases, 25(4).
Centers for Disease Control and Prevention. (2019). Tuberculosis — United States, 2018. Morbidity and Mortality Weekly Report (MMWR), 68(11), 257–262.
Centers for Disease Control and Prevention. (2018). Tuberculosis.
Centers for Disease Control and Prevention. (2016). Fact Sheet: Diagnosis of Tuberculosis Disease.
Centers for Disease Control and Prevention. (2014). TB in Children in the United States.
Centers for Disease Control and Prevention. (2010). Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium tuberculosis Infection. Morbidity and Mortality Weekly Report (MMWR), 59(RR05), 1-25.
Centers for Disease Control and Prevention. (2018). Update of Recommendations for Use of Once-Weekly Isoniazid-Rifapentine Regimen to Treat Latent Mycobacterium tuberculosis Infection.
Starke, J. R. & Cruz, A. T. (2014). The global nature of childhood tuberculosis. Pediatrics, 133(3), e-725.
Texas Health and Human Services, Texas Department of State Health Services. (2019). Infectious Disease Control Unit: Tuberculosis.
Texas Health and Human Services, Texas Department of State Health Services. (2019). TB Statistics.
Texas Health and Human Services, Texas Department of Health Services. (2018). Texas TB Surveillance Report.
Texas Health and Human Services, Texas Department of State Health Services. (2018). TB Facts.
World Health Organization. (2018). Best Practices in Child and Adolescent Tuberculosis Care.
University of Rochester Medical Center. (2019). Health Encyclopedia: Tuberculosis (TB) in Children.
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02548
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