Tuberculosis Section (TB)

Contact Investigation/Directly Observed Therapy

Contact investigations are complicated undertakings that typically require hundreds of interdependent decisions, the majority of which are made on the basis of incomplete data, and dozens of time-consuming interventions. Making successful decisions during a contact investigation requires use of a complex, multifactor matrix rather than simple decision trees. It is definitely a team activity. Every single TB case began as someone’s contact.

Directly Observed Therapy (DOT) is an essential element for the prevention of further transmission of infection and disease. The ultimate purpose is to have each patient fully complete his/her first-ever TB treatment. DOT entails the direct observation of the patient’s self administering and swallowing the correct dose of anti-tuberculosis medications at the proper time for the complete period of therapy by a designated, trained and responsible agent of the patient. However, DOT is not just providing medication. DOT involves front line interaction with the patient. The DOT worker has the opportunity to make a genuine contribution not only to the patient’s physical health but also his or her well-being. Every DOT encounter is an opportunity to identify contacts, hobbies and locations where the index case may have exposed other people.

This is a one day workshop that prepares a public health employee to define an index case, identify 6 index case characteristics used in determining the priority of an investigation, list 4 factors used to decide the priority of a contact, discuss the time frame in which high and medium priority contacts should be screened, and demonstrate open-ended questions. The day is spent in lectures, videos, discussions and role-play.

Topics include:

• Medical Record Review & Investigation Priorities
• Interviewing the Index Case
• Field Investigation
• Risk Assessment of TB Transmission
• Decision About Priority of Contacts
• Evaluation of Contacts
• Treatment of Contacts
• Decision About Expanding an Investigation
• Evaluation of Investigation Activities
• Data Collection and Documentation
• Directly Observed Therapy (DOT)
• Definitions, Roles, Responsibilities & Policies
• Assessment of Adherence
• Procedure
• Case Studies

Click here to download the registration form.