Tuberculosis Section (TB)

Services Available

Who is eligible?

TB Program provides services to TB suspects, TB cases and contacts of TB cases are provided at no charge, regardless of ability to pay. Services to others are available for a nominal fee.

Medical consultation

Community-based TB control, along with universal Directly Observed Therapy (DOT), has become the standard of care in Georgia. Physician consultants located in each Health District provide clinical management to TB patients in their communities.

A medical consultant and TB epidemiologist are available for consultations for difficult to treat TB cases (e.g., MDR-TB). In addition, the TB Program physician provides recommendations for treatment of TB and medical consultation to local health departments, private physicians, district contract physicians and other providers and agencies as requested. All TB cases in the state are reviewed to ensure quality and appropriate treatment regimens.

Chest x-rays

The TB Program provides chest x-rays for persons suspected of having active TB disease, TB cases and high-risk contacts of TB cases. Chest x-rays for follow up of a positive skin test as a result of routine testing or in conjunction with employment, school, etc. are provided at a nominal cost.

Laboratory

The Georgia Public Health Laboratory provides AFB smear tests and confirmation of positive cultures for local health departments, private physicians and hospitals. Sensitivity studies are performed on cultures to detect drug resistant TB and multi-drug resistant TB. Other tests to aid in the diagnosis of TB such as PCR testing and MTD testing can be done. Blood tests are performed in the local health departments to monitor persons on TB medications. These may include liver function tests (LFT, AST, ALT, Bilirubin), complete blood counts (CBC), serum uric acid or serum creatinine.

Medication

Anti-tuberculosis drugs are provided by the state pharmacy to districts and counties. Persons with TB can receive their medication free of charge through the local health departments during monthly evaluations. It is the standard of care that all persons with active TB disease have directly observed therapy (DOT) during the course of treatment. DOT is when the person swallows each dose of the medication in front of a non-family member who documents each dose completed. This ensures that every dose is taken and helps to prevent multi-drug resistant strains of TB.

Purified protein derivative (PPD) for tuberculin skin testing is supplied by written agreement to local health departments, nursing homes and substance abuse centers. Other local agencies may be able to enter into agreements with local health departments or districts to supply PPD for tuberculin skin testing. All agreements must include reporting & tracking of all medication and tests.

Case management

The TB Program has the legal responsibility for all TB clients in Georgia regardless of who provides the direct services. County health departments are ultimately responsible for the medical supervision and case management of all known cases and suspects within each county in order to prevent the spread of tuberculosis. The county TB nurses and the district TB Coordinators work together with private physicians, district contract physicians and the State TB Program to provide quality care and appropriate treatment regimens to all persons with TB.

Contact investigation

Tuberculosis is a public health problem that can negatively impact our communities. A contact investigation is done to identify, evaluate and treat persons who have been exposed to active TB disease in order to prevent the continuing transmission of tuberculosis. A healthcare worker interviews each suspect and/or case of TB for all known contacts. The health department will then notify the named contacts. Each contact will be encouraged to obtain an evaluation and TST. In addition, on-site visits will be made to the workplace, school, home and social areas where the sick person may have exposed others to the disease. The name of the person with TB is not released without the written permission of the client.

Medical Records

The medical records department establishes, updates & maintains charts for all tuberculosis suspects and/or cases. An automated client management and surveillance system is maintained. Documentation is obtained and distributed for out of state contacts and cases. Medical records are maintained for at least twenty (20) years.

Surveillance & epidemiology

Data is analyzed to describe TB occurrences, TB deaths, trends and local geographical characteristics of TB cases. TB incidence in high-risk populations, appropriateness of TB treatment regimens and resistance levels to anti-tuberculosis drugs are monitored. Surveillance, epidemiological analysis and evaluation data is provided to districts and counties as requested.

Education & Training

Educational programs are provided for health departments, nursing homes, hospitals, correctional facilities, substance abuse centers, homeless shelters, private industries and all other public and private entities as requested. Consultation is provided on general concerns regarding tuberculosis management, infection control and other issues as requested. Site visits to local county health departments and district facilities are conducted for quality assurance and quality improvement.

Community Partnerships

The program works closely with the Atlanta Tuberculosis Coalition, TB Task Force, and the American Lung Association of Georgia, as well as other community-based organizations.