Improving Screening for Latent Tuberculosis Infection in a Student-run Free Clinic

Abstract

IntroductionLatent tuberculosis infection (LTBI) screening with targeted treatment has been successful in eradicating tuberculosis (TB) as an endemic infection in the United States. The Centers for Disease Control and Prevention (CDC) recommends screening for high-risk patients. The aim of this study was to increase LTBI screening, detection, and treatment in our student-run free clinic while providing an innovative platform for education in primary care topics.MethodsA questionnaire for screening for LTBI was adapted from CDC guidelines. Medical students and providers received education on the screening process and administered questionnaires to patients. We analyzed the rate of performed LTBI screening, the rate of diagnostic testing for patients with positive screening, and the feasibility of implementing a preventive screening initiative.ResultsFifty-two patients completed primary care visits. Forty patients were screened for LTBI. Of those screened, 42.5% were positive for the screening. Of those with positive screening, 70.6% were followed up via diagnostic testing, with the rest of them being lost for follow-up due to not attending the clinic for care.ConclusionsThis educational intervention combined with a screening tool was effective in increasing LTBI screening rates amongst patients in a student-run free clinic.

Healthcare facility-based strategies to improve tuberculosis testing and linkage to care in non-U.S.-born population in the United States: A systematic review

“…Anand and colleagues (2018) conducted a pre-post study from December 2015 to February 2017 at The Keeping Neighbors In Good Health Through Service (KNIGHTS), which provides free care to underserved populations in Orange County, Florida. [26] The pre-post study was a multifaceted quality improvement project aimed at improving provider and staff compliance to CDC LTBI screening guidelines. [29] The intervention consisted of educational training sessions for providers and clinic staff as well as the development of an LTBI screening tool (questionnaire) for clinic use, which was adapted from CDC LTBI screening guidelines.…”

“…The other six studies were non-randomized. [22, 24–26, 28, 31] Among five,[22, 24–26, 31] none blinded participants, personnel or outcome assessors to the intervention status. This information was unclear in Tanke 1994.…”

“…[28] With study protocols unavailable, the risk of outcome reporting bias in all studies was also unclear. Three studies[22, 26, 28] used clinic records or administrative data. In two studies,[24, 31] groups were socio-demographically comparable from baseline to intervention, but comparability of groups was unclear because of lack of reported data for both phases in the four others.…”

“…In two studies,[24, 31] groups were socio-demographically comparable from baseline to intervention, but comparability of groups was unclear because of lack of reported data for both phases in the four others. [22, 25, 26, 28]…”

Interventions for Increasing the Quality of Preventive Care at a Free Clinic

“…Using previously published data [9][10][11][12], quality committee members' input, and an interdisciplinary team approach, four interventions were designed in order to address six quality measures.…”