January 2022

Updated Pocket Card: Diagnosis and Treatment of Latent Tuberculosis Infection (LTBI) in Adults

Rutgers Global TB Institute has updated this pocket card based on the most recent treatment recommendations from CDC and the National Tuberculosis Controllers Association. The card has been substantially revised to meet the needs of clinicians, especially those in primary care settings. Using a stepwise approach, the card provides brief practical information on identifying those at risk for TB, testing, diagnosis, and treatment of LTBI in adults. 

2022 National TB Conference: Save the Dates and Call for Abstracts

Save the date for the 2022 National TB Conference (NTC) on May 24-26, 2022 in Palm Springs, CA. The planning committee also announces the Call for Abstracts, due Friday, January 14, 2022, at 9:00 PM, PT. The 2022 conference program will be posted on the NTCA website. For questions, please email 2022NTC@tbcontrollers.org.

Information for Local Health Jurisdictions

We are here for you but communication is key

We realize your LHJ may be experiencing capacity issues with the current COVID-Omicron surge. Please reach out to us if you are having trouble meeting any of our end-of-year closeout deadlines. During this stressful time, we are also available to help with your TB case management and contact investigations. Please let us know how we can help. You can reach us thru email at TBServices@doh.wa.gov or by phone at 206-418-5500.

2021 Reporting Deadlines

Rifampin Shortage Update

Though current local drug wholesalers may be out of rifampin we have

Good News. Some of the CDC rifampin 300mg (expires 4/30/2022) that we requested from the CDC National Stockpile has arrived at the King County pharmacy. 

We have no idea how long this shortage may last. Please consider using this CDC medication first and save any other rifampin with expirations after 4/30/2022. We ordered a quantity large enough from CDC to try to cover your patients until the end of April.

You will find a special order form on the TB Program’s LHJ SharePoint page here: Former CDC Medication Stockpile Page

BPaL Access for Medicaid Patients

We have been working with Health Care Authority (HCA) on their Medicaid formulary with the goals of removing barriers and reducing delays to accessing two of the three medications (pretomanid, bedaquiline, linezolid) in the BPaL regimen.  

We have some great news:

1. HCA is working on a solution for Medicaid coverage denials when trying to acquire bedaquiline* from its sole source Metro Medical pharmacy, which is unfortunately out-of-stateand not an approved supplier. Bedaquiline is already listed as a preferred drug in the formulary.
2. HCA has agreed to remove the prior authorization requirement for pretomanid.

Linezolid is already listed as a preferred drug in the HCA formulary.

We are waiting to receive an implementation date from HCA. Until these changes go into effect, if you run into issues with accessing either of these medications for your patients with Medicaid, reach out to HCA for support at this email box: AppleHealthPharmacyPolicy@hca.wa.gov. 

Of course, please feel free to reach out to our program as well: tbservices@doh.wa.gov 

Upcoming Events and Education Opportunities

January 20, 2022 | A Conversation with CDC Partners

1:00 pm, PT. This 2021 Hep B United / TB Elimination Alliance Summit: Centering Community to Advance Health Equity session was rescheduled. Register here.

February 2, 2022 | Achieving Treatment Completion for Drug-Susceptible TB: Rarely a Straight Path

This is the fourth in a series of virtual TB Case Management and Contact Investigation Intensive (CMCI) trainings occurring during the second half of 2021. Register here.

Thursdays in February 2022 | Quality Improvement Strategies for LTBI Screening, Testing, and Treatment in A/AA and NH/PI-Serving Health Centers: EHR Template Development

12:30 - 2:00 pm , PT. This TB Elimination Alliance Learning Collaborative explores quality improvement strategies for standardized data collection through electronic health record (EHR) template development. Register here.

May 24-26, 2022 | 2022 National TB Conference

The National TB Controllers Association (NTCA) and the California TB Controllers Association (CTCA) announced plans for a co-sponsored, in-person national TB conference in Palm Springs, CA. More details to come.

Washington's TB Project ECHO

12:30-1:30 pm PT. On Mondays join our lunch-time virtual discussion about real TB cases with your peers. This free interactive event is guided by a panel of local TB experts. For more information about this local project and our partners who make this ongoing event possible.

Articles

Comparative Efficacy of Rifapentine Alone and in Combination with Isoniazid for Latent Tuberculosis Infection: a Translational Pharmacokinetic-Pharmacodynamic Modeling Study

Antimicrobial Agents & Chemotherapy | 11/17/2021 | doi: 10.1128/AAC.01705-21 | Read here

Knowledge, attitudes and practices on tuberculosis infection prevention and associated factors among rural and urban adults in northeast Tanzania: A cross-sectional study

PLOS Global Public Health | 12/8/2021 | doi: 10.1371/journal.pgph.0000104| Read here

Treating latent tuberculosis infection (LTBI) with isoniazid and rifapentine (3HP) in an inner-city population with psychosocial barriers to treatment adherence: A qualitative descriptive study

PLOS Global Public Health | 12/8/2021 | doi: 10.1371/journal.pgph.0000017 | Read here

Antibiotic pre-resistance spotted in tuberculosis bacteria for the first time

Science Focus | 12/15/2021 | Read here

TB Notes 4, 2021

CDC's Division of TB Elimination | Read here

Videos and Recordings

CITC Archived Webinars

CME/CE units will not be offered for these trainings. Access here.

Rutgers TB Institute Archived Trainings

CE units are available for these webinars. Access here.

SNTC Archived Webinars

CME/CE units will not be offered for these trainings. Access here.

TB ECHO Recorded Archives

Missed a TB ECHO^® session? TB ECHO^® has didactic presentations available for viewing on YouTube. Handouts related to the presentation are included where appropriate. Watch recorded TB ECHO® here

Tools and Resources

For LHJs: Delivery Express Courier

• Contact tbservices@doh.wa.gov for information about courier services for TB specimens from your local health jurisdiction to the Public Health Lab.

CDC

• CDC Guidance of COVID mRNA Vaccines, TST, and IGRA: Scroll to the "People undergoing testing for tuberculosis infection" section
• CDC Learning Connection.
• CDC TRAIN is a comprehensive catalog of free public health training opportunities from the Public Health Foundation. For TB-related trainings, click here.
• FindTBResources.cdc.gov - TB educational materials for patients and providers.
• Visit Everyday Words for Public Health Communication to find plain language alternatives for public health jargon.
• TB Personal Stories patient videos to help raise awareness about TB in the US.
• we are TB offers comprehensive peer support for current TB patients and TB clinics, including weekly live support group sessions.
• Subscribe to the CDC's quarterly newsletter, TB Notes!

Heartland National TB Center

• Stop the Stigma: Eliminating Stigmatizing Language Resources

Southeastern National TB Center

• Individualized Country Guides to support the provider-foreign-born client relationship.

National Society of Tuberculosis Clinicians

• Testing and Treatment of Latent Tuberculosis Infection in the United States: Clinical Recommendations, a companion reference to support health care providers in implementing the 2020 “Guidelines for the Treatment of Latent Tuberculosis Infection: Recommendations from the National Tuberculosis Controllers Association and CDC.

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