SOBAZ NIGERIA LIMITED

Tuberculosis Program Manual Template

The Tuberculosis Program Manual Template is a set of fully editable

Word
files that provides standardized guidance to public health staff in
a low-incidence region.
Created from the latest Centers for Disease Control and Prevention
(CDC) guidelines, expert opinion, and input from an advisory panel of
representatives from the four states (Idaho, Montana, Utah, and
Wyoming), the Tuberculosis Program Manual Template covers a
comprehensive range of topics designed to meet the needs of low-
incidence states/jurisdictions.
This template addresses the following topics:

 Surveillance
 Targeted Testing
 B Notifications
 Diagnosis of Tuberculosis Disease
 Treatment of Tuberculosis Disease
 Diagnosis of Latent Tuberculosis Infection
 Treatment of Latent Tuberculosis Infection
 Case Management
 Contact Investigation
 Laboratory Services
 Patient Education
 Confidentiality
 Transfer Notifications
 Supplies, Materials, and Services
 Infection Control

tuberculosis (TB) infection control plan is part of a general infection control

program designed to ensure the following:

 prompt detection of infectious TB patients,

 airborne precautions, and
 treatment of people who have suspected or confirmed TB disease.
In all health care settings, particularly those in which people are at high risk
for exposure to TB, policies and procedures for TB control should be
developed, reviewed periodically, and evaluated for effectiveness to
determine the actions necessary to minimize the risk for transmission of TB.

The TB infection control program should be based on a three-level hierarchy

of control measures and include:
 1. Administrative measures
2. Environmental controls
3. Use of respiratory protective equipment

Administrative controls are the first and most important level of the
hierarchy. These are management measures that are intended to reduce the
risk or exposure to persons with infectious TB. These control measures
consist of the following activities:

 Assigning someone the responsibility for TB infection control in the

health care setting;
 Conducting a TB risk assessment of the setting;
 Developing and implementing a written TB infection-control plan;
 Ensuring the availability of recommended laboratory processing,
testing, and reporting of results;
 Implementing effective work practices for managing patients who may
have TB disease;
 Ensuring proper cleaning, sterilization, or disinfection of equipment
that might be contaminated (e.g., endoscopes);
 Educating, training, and counseling health care personnel, patients,
and visitors about TB infection and TB disease;
 Screening, testing, and evaluating personnel who are at risk for
exposure to TB disease;
 Applying epidemiology-based prevention principles, including the use
of setting-related TB infection-control data;
 Using posters and signs to remind patients and staff of proper cough
etiquette (covering mouth when coughing) and respiratory hygiene;
and
 Coordinating efforts between local or state health departments and
high-risk health-care and congregate settings.

The second level of the hierarchy is the use of environmental controls to

prevent the spread and reduce the concentration of infectious droplet nuclei.
This includes two types of environmental control.
  Primary environmental controls consist of controlling the source of
infection by using local exhaust ventilation (e.g., hoods, tents, or
booths) and diluting and removing contaminated air by using general
ventilation.
 Secondary environmental controls consist of controlling the airflow to
prevent contamination of air in areas adjacent to the source airborne
infection isolation (AII) rooms; and cleaning the air by using high
efficiency particulate air (HEPA) filtration, or ultraviolet germicidal
irradiation.

The third level of the hierarchy is the use of respiratory-protection control. It

consists of the use of personal protective equipment in situations that pose a
high risk of exposure to TB disease.

Use of respiratory protection equipment can further reduce risk for exposure
of health care personnel to infectious droplet nuclei that have been expelled
into the air from a patient with infectious TB disease. The following measures
can be taken to reduce the risk for exposure:

 Implementing a respiratory protection program;

 Training health care personnel on respiratory protection; and
 Educating patients on respiratory hygiene and the importance of cough
etiquette procedures.