tailieunhanh - Management of Tuberculosis - Federal Bureau of Prisons Clinical Practice Guidelines January 2010

TB incidence in the United States decreased during the past decade, largely as a result of more intensive TB control efforts. Nevertheless, TB control remains a public health priority for correctional systems, since TB outbreaks continue to occur in . jails and prisons. Furthermore, a significant proportion of TB cases in the . occur among persons who are over-represented in certain jails or prisons, including racial/ethnic minority populations, persons with human immunodeficiency virus (HIV) infection, and persons born in foreign countries that have high rates of TB. M. tuberculosis, the organism that causes TB, is transmitted through airborne respiratory droplets when. | Management of Tuberculosis Federal Bureau of Prisons Clinical Practice Guidelines January 2010 Clinical guidelines are being made available to the public for informational purposes only. The Federal Bureau of Prisons BOP does not warrant these guidelines for any other purpose and assumes no responsibility for any injury or damage resulting from the reliance thereof. Proper medical practice necessitates that all cases are evaluated on an individual basis and that treatment decisions are patient-specific. Consult the BOP Clinical Practice Guideline web page to determine the date of the most recent update to this document http news . Federal Bureau of Prisons Clinical Practice Guidelines Management of Tuberculosis January 2010 What s New in the Document This is a targeted revision of the guideline regarding TB screening. Changes since the April 2007 version of the document are highlighted in YELLOW. 1. For non-English speaking inmates it is critical that TB symptom screening questions be asked via an interpreter either in-person or via language line . 2. A baseline tuberculin skin test TST should generally be obtained on all new intakes to the BOP regardless of TST results from local jails and regardless of an inmate s history of a prior positive TST with the following exceptions The inmate has prior documentation of a positive TST while the inmate was incarcerated within the BOP The inmate has a history of a severe reaction to a TST . swollen blistering vesiculated reaction either by self-report or clinically documented The inmate provides a credible history of treatment for latent TB infection . is able to describe the medication taken and when where and how long it was taken. There is a unique reason not to repeat a TST as approved by the Regional Medical Director . repeated admissions from local detention facilities over a short period of time. 3. Two-step tuberculin skin testing see page 5 should be performed on all foreign .