FOR IMMEDIATE RELEASE:
NSTC/NTCA Release New Publication Testing and Treatment of Latent Tuberculosis Infection in the United States: Clinical Recommendations
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February 5, 2021
Smyrna, GA – The National Society of Tuberculosis Clinicians (NSTC), a section of the National Tuberculosis Controllers Association (NTCA) is pleased to announce the release of the Testing and Treatment of Latent Tuberculosis Infection in the United States: Clinical Recommendations. Led by NSTC members Drs. Marcos Burgos and Charlie Crane, a national group of TB experts developed these patient-centered and practical state-of-the-art recommendations as a companion reference to support health care providers in implementing the 2020 latent tuberculosis infection (LTBI) treatment recommendations, "Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC."
Dr. Burgos explains the project's scope, "Our group strove to explain how to put the clinical advances of these guidelines into practice in the broader context of comprehensive patient care for LTBI—from screening and testing, to deciding whether and how to treat, and through to treatment completion. Further, we wanted to take a patient-centered approach and to present current thinking among TB clinicians on clinically complicated situations, such as pregnancy, human immunodeficiency virus (HIV) infection, liver disease, and organ transplantation."
The Clinical Recommendations are written for health care providers in both the public and private sectors, both essential in the effort to eliminate TB disease. Dr. Crane emphasizes the importance of engaging private providers in the treatment of LTBI, “TB elimination cannot be accomplished by public health efforts alone; we need to partner with our private provider colleagues as they care for those with TB infection."
Pete Dupree, MPH, current president of NTCA and the TB Program Manager for Colorado, gives the state TB programmatic perspective, "This guidance document has been years in the making with input and support from the top subject matter experts in the country. As a state TB Program Manager and TB Controller, I know the paramount importance of scaling-up screening, testing, and treatment for TB infection. Expanding TB infection treatment to private providers will be the key to reaching TB elimination globally, nationally and locally."
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About the Authors and Reviewers |
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The authors and reviewers include clinicians and nurses with involvement and experience in tuberculosis from multiple perspectives from their professional roles in patient care, public health, and scientific research and represent areas with different epidemiology and public health infrastructure and resources across the United States. Many, if not all, have been regularly involved in sharing their clinical expertise by consulting or teaching.
Their medical background, clinical experience, and involvement in current academic research based the recommendations on the best available current knowledge--either research- or expert opinion-based. Their familiarity with questions that other providers pose and their experience in direct patient care focused the recommendations on practical application. Finally, but importantly, their dedication to patients fostered a patient-centered approach to evaluation and treatment.
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Audiences
Target audiences for this document include health care providers in public health departments, hospitals, congregate facilities, and private practices, including the following:
- Public health departments and TB programs
- Community clinics
- Hospitals
- Private medical practices
- Congregate facilities such as long-term care facilities, homeless shelters, correctional facilities
Contents
The recommendations provide a comprehensive reference on LTBI:
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Immunologic Tests for TB Infection: in-depth review of available tests and instructions on test selection and clinical interpretation
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When to Test for LTBI: recommendations building on recent public health work on TB risk assessment by the California Department of Public Health and testing of health care personnel by NTCA, CDC, and ACOEM
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Pretreatment Clinical Evaluation: practical steps to diagnose LTBI
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Deciding Whether to Treat and Choosing a Regimen: a patient-centered approach to using the 2020 clinical treatment guidelines and a review of each regimen
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Considerations for Specific Populations: expert perspectives on testing and treatment of children; pregnant, postpartum, and breastfeeding women; recent contacts to pan-susceptible and drug-resistant TB; and patients with comorbidities such as human immunodeficiency virus (HIV) infection, diabetes, kidney disease, liver disease, substance use disorders, and iatrogenic immunosuppression during treatment with biologics, cancer treatment, and organ and bone marrow transplantation
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Monitoring and Managing Treatment: regular assessment and monitoring with recommendations on how to approach adverse effects, treatment interruption, regimen change, and treatment follow-up
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Nurse Case Management: brief overview with links for further information
Appendices include reference information on TB test interpretation, drugs used to treat LTBI, dosages for treatment regimens, collaborations between public health and community service providers, and directly observed therapy and video observed therapy.
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The Testing and Treatment of Latent Tuberculosis Infection in the United States: Clinical Recommendations is available for download here. So that we can provide email alerts when the document is updated and keep an aggregated count of downloads, we ask that you register with your email address in order to download the document.
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Updates and Contact Information |
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Future Updates
About NTCA
For more information about the Clinical Recommendations, contact:
Jennifer Kanouse, MA
Director of Communications
National Tuberculosis Controllers Association
2452 Spring Road, SE
Smyrna, GA 30080
678-503-0503
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