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Source: http://www.commed.vcu.edu/IntroPH/Communicable_Disease/communicable_diseases_ol.htm

Tuberculosis lecture by

Jane L. Moore, RN, MHSA, Virginia Department of Health  Uploading date: May 21, 2012

 

Review this slide show presentation on  Tuberculosis: Part 1. Then look at the example of goal setting to reduce TB incidence and be prepared to discuss the epidemiological basis for such goal setting. Even though this slide is more than 30 years old there are still lessons to be learned today.  Although increasing, there are still few only a few instances of community analysis and results oriented programming and evaluation on the web.   Also, review at the CDC web pages devoted to TB, HIV & STDs and click on Dr Fenton's blog. Finally look at a discussion of a recent TB outbreak in New York compared to one in London, UK (Second item under Perspective). Where was the information published? Why do you think I selected this topic? Consider why TB persists today with all our antibiotics.  Take a look at the Global Issues defined by the WHO (look at some of the publications on the right side of the screen). Scan at the WHO global plan to STOP TB and the reprint from the NEJM of global TB. You may wish to visit the PBS Deadly Diseases - TB site All of you should watch the 4 minute video (part III).  Also students from outside the US who have seen the effectiveness of BCG in TB prevention, look at this article from the Lancet (April 2006) and try to determine why BCG is not used in the US. A recent article on the planned use of BCG in London is worth reviewing,as is this report in the Guardian. Also look at this editorial on BCG use in Developing Countries (the second editorial). The latest informationon a new test for TB  The [WHO] has endorsed a new rapid test for tuberculosis use worldwide.  Review the articles on the [WHO] website.  How will this new test be a game changer for TB diagnosis and morbidity?
Blood testing for TB infection - http://www.medscape.com/viewarticle/738519
                Pros and cons of available blood tests over tuberculin skin test
                Do you agree with the current CDC recommendations – if you were making policy what would you change?
Program evaluation for TB Control – are we evaluating the right indicators?  Review the 15 national TB Program indicators.  How will improvement on these indicators improve TB Control in the United States? http://www.cdc.gov/tb/publications/factsheets/statistics/NTIP.htm. Look at this short editorial from the Lancet. Finally a recent report on TB Trends in the USA from the MMWR.

References:
The BCG Quandary (pdf)
BCG Effectiveness (pdf) 
Stopping BCG in the UK 
TB & AIDS, Recent JAMA Article
TB among Foreign Born in US, JAMA, July 08
What is Thwarting Tb Prevention - Editorial NEJM, July 2011

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