Provider Resources
Educational resources and technical assistance for TB-care
LTBI Research & Recommendations
City Health Information: Testing for and Treating Latent Tuberculosis Infection
June 7, 2021
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control
Tuberculosis (TB) remains an important public health concern in New York City. Identification and treatment of people with latent TB infection (LTBI) is essential to TB prevention efforts. The Health Department identified a 5 step protocol to optimal LTBI testing and treatment:
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Screen all patients for TB risk factors;
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Test patients at high risk for TB infection using a blood-based interferon gamma release assay (IGRA) as indicated;
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Rule out active TB disease in patients with a positive test for TB infection;
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Treat patients with LTBI using short-course regimens and ensure treatment completion;
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Report TB infection test results and LTBI treatment as required by the Health Code.
Access the full recommendation HERE.
Four Months of Rifampin or Nine Months of Isoniazid for Latent Tuberculosis in Adults
Menzies, D, M.D., Adjobimey, M, M.D., M.P.H., Ruslami, R, M.D., Ph.D., et.al.
August 2, 2018
New England Journal of Medicine
With an estimated one-quarter of the world infected with latent TB, shorter, effective treatment regimens are needed to treat the reservoir of disease. This study investigated the efficacy and adherence rates between adults treated for latent TB infection with either 9 months of isoniazid or 4 months of rifampin.
Study findings show the 4-month regimen of rifampin was not inferior to the 9-month regimen of isoniazid for the prevention of active TB and was associated with a higher rate of treatment completion and better safety.
Access the full study HERE.
USPSTF Recommendation: Screening for Latent Tuberculosis Infection in Adults
US Preventative Services Task Force
September 6, 2016
Journal of the American Medical Association
TB remains an important preventable disease in the United States. An effective strategy for reducing the transmission, morbidity, and mortality of active disease is the identification and treatment of latent TB infection (LTBI) to prevent progression to active disease.
The United States Preventive Services Task Force (USPSTF) found adequate evidence that accurate screening tests for LTBI are available, treatment of LTBI provides a moderate health benefit in preventing progression to active disease, and the harms of screening and treatment are small. The USPSTF recommends screening for LTBI in populations at increased risk (B recommendation).
Access the full recommendation HERE.
Active Case Finding and Prevention of Tuberculosis Among a Cohort of Contacts Exposed to Infectious Tuberculosis Cases in New York City
Anger, H, Proops, D, Harris, TG, et.al.
October 15, 2012
Clinical Infectious Diseases
TB contact investigation identifies individuals who may be recently infected with TB and are thus at increased risk for disease. This study utilized New York City-specific data to retrospectively analyze TB contacts identified during investigations for active TB cases between 1997-2003.
Findings from the study conclude that contact investigation facilitates active case finding and TB prevention, even when completion rates of chemoprophylaxis are suboptimal.
Access the full study HERE.
Risk for Tuberculosis Disease Among Contacts with Prior Positive Tuberculin Skin Test: A retrospective Cohort Study, New York City
Gounder, PP, M.D., M.P.H., Harris, TG, Ph.D., M.S., Anger, H, M.P.H., et.al.
June 2015
Journal of General Internal Medicine
This study evaluated factors associated with active TB disease among persons with prior positive TST results named as contacts of persons with infectious TB. Using data from 2,933 contacts with prior positive TST results recently exposed to infectious TB identified in New York City’s TB registry during the period from January 1, 1997 through December 31, 2003.
Based on findings, healthcare providers should consider prophylaxis for contacts with prior TB infection, especially young children and close contacts of TB patients (e.g., those with household exposure).
Access the full study HERE.
MDR-TB Treatment Guidance
WHO consolidated guidelines on drug-resistant tuberculosis treatment (2019)
World Health Organization
Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). WHO has consolidated guidelines on the most recent and available evidence-based drug-resistant tuberculosis treatment to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB.
Access the publication HERE.
New York City guidance for the treatment of MDR-TB
February 4, 2019
New York City Department of Health and Mental Hygiene, Bureau of Tuberculosis Control
In January 2019, the New York City Department of Health and Mental Hygiene convened local and national experts to discuss new recommendations for the treatment of MDR-TB from the World Health Organization. Based on this meeting, the Health Department crafted NYC-specific recommendations.
Read the treatment guide HERE.
Non-Stigmatizing TB Language
Stop the Stigma: Eliminating Stigmatizing Language
Heartland National Tuberculosis Center
As TB control programs move toward more patient centered care, the use of non-stigmatizing language in clinical care is increasingly important. In the publication, Every Word Counts: Suggested Language and usage for TB Communications, the authors describe how judgmental terms and negative connotation of words such as 'defaulter' and 'suspect' place blame for the disease and responsibility for adverse treatment outcomes on the patient.
Access the resource(s) HERE.
Technical Brief | Tuberculosis, Gender, and Human Rights
February 2020
The Global Fund
The purpose of this Technical Brief is to assist individuals and programs on how to remove human rights and gender-related barriers to TB prevention, diagnosis and treatment services within funding requests and to help all stakeholders ensure that TB programs promote and protect human rights and gender equality.
Access the technical brief HERE.
United to End TB: Every Word Counts
November 3, 2015
Stop TB Partnership
The Stop TB Partnership launched ‘United to End TB: Every Word Counts’, the first language guide for partners and stakeholders working in tuberculosis. The language guide supports the call for change in the upcoming Global Plan to End TB 2016-2020, which includes ‘changing the mindset, language, and dialogue on TB’ as one of the key paradigm shifts required to reach the End TB Goals.
Access the technical brief HERE.
TB Elimination Plans
California Tuberculosis Elimination Plan 2016-2020
July 2016
California Tuberculosis Elimination Advisory Committee
The purpose of the California TB Elimination Plan is to outline actions that can be taken to ensure that the large population of Californians who have latent TB infection (LTBI) are evaluated and successfully treated. It is expected that these actions will prevent TB disease in individuals and accelerate the time to TB elimination in California. Intensifying targeted testing and treatment of LTBI must occur in parallel to ongoing TB disease testing and treatment efforts by strong public health departments. It is critical that the detection of TB disease be timely, that treatment be effective and that contact investigations are completed.
Access the plan HERE.
Framework towards tuberculosis elimination in low-incidence countries
2014
World Health Organization
The World Health Organization framework offers a coherent approach for eliminating TB in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national TB response in accelerating efforts towards elimination. The document will also be informative for public health surveillance officers, practitioners and non-governmental and civil society partners working on national TB care and prevention and serving the populations most vulnerable to TB.
Access the framework HERE.
Interactive civil society hearing on the fight against tuberculosis
June 4, 2018
United Nations
In preparation for the September 2018 United National High-Level Meeting on TB (UN HLM), an interactive civil society hearing was held on June 4, 2018 in New York City. The June and September 2018 meetings follow a productive Ministerial Conference on Ending TB in Moscow in November 2017 which resulted in high-level commitments from Ministers and other leaders from 120 countries to accelerate progress to end TB. The hearing aims for the active participation of “appropriate senior-level representatives of Member States, observers of the General Assembly, parliamentarians, representatives of local government, relevant United Nations entities, non-governmental organizations in consultative status with the Economic and Social Council, invited civil society organizations, academia, medical associations and the private sector, as well as people affected by TB and broader communities, ensuring the participation and voices of women, girls, and indigenous leadership as part of the preparatory process for the high-level meeting”.
Access the recorded hearing HERE.
Division of Tuberculosis Elimination Strategic Plan 2016-2020
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC), Division of TB Elimination’s (DTBE) strategic plan focuses on the following goals:
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Domestic: Eliminate TB in the United States (defined as ≤1 case/million)
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Global: Contribute to reductions in global incidence and mortality by 50% each (compared to 1990 baseline, based on the Stop TB Partnership Global Plan to Stop TB (2006-2015)
DTBE has been carrying out strategic planning sessions periodically since 1989, using surveillance data and scientific findings to identify new directions. Depending on funding availability, DTBE launches new projects through an internal peer-review process, selecting those with the greatest potential for having an impact on eliminating TB.
Access the strategic plan HERE.
TB-Related Websites
New York City Department of Health and Mental Hygiene
Bureau of Tuberculosis Control
As one of the leading providers of TB care in New York City, the New York City Department of Health and Mental Hygiene's website offers key resources to providers and community members about TB. Resources available on the website include provider reporting requirements, TB risk assessments, multilingual educational resources, and much more.
Go to the website HERE.
​​Centers for Disease Control and Prevention
Division of Tuberculosis Elimination
The Centers for Disease Control and Prevention's (CDC) Division of TB Elimination's (DTBE) website provides publicly available information on latent TB infection (LTBI), drug resistant TB, and infection control practices. Additional resources available include current TB research, data and statistics on TB throughout the United States, and stories highlighting the personal experiences of patients with TB.
Go to the website HERE.
Rutgers Global Tuberculosis Institute
The Global TB Institute at Rutgers, The State University of New Jersey is one of four National TB Centers of Excellence (COE) funded by the Centers for Disease Control and Prevention (CDC). Our COE provides training, technical assistance, and medical consultation to healthcare professionals throughout 20 project areas in the Northeastern United States. The website offers information on education and training sessions, TB consultation, and clinical services as well as research and global TB programs.
Go to the website HERE.
World Health Organization
Global Tuberculosis Programme
The World Health Organization (WHO) Global Tuberculosis Programme leads and guides the global effort to end the TB epidemic through universal access to people-centered prevention and care, multisectoral action, and innovation.​
The team provides strategy and standards for TB prevention and care; shapes TB research and innovation; and monitors, evaluates, and reports on the status of the TB epidemic and progress in financing and implementing the End TB Strategy at global, regional, and country levels.
Go to the website HERE.