1. 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 Pathogenesis Phase 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 Sciences
Texas 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”