Latent Tuberculosis Infection Testing and Treatment at a Federally Qualified Health Center in Southern California

Abstract

Background:A key strategy to eliminate tuberculosis (TB) in the United States is to increase latent tuberculosis infection (LTBI) screening, testing, and treatment among non-US-born Asian populations. Purpose: The purpose was to increase LTBI screening, testing, and treatment at a community clinic. Methods: Retrospective baseline LTBI data were retrieved through electronic medical record review. Interventions included adoption of standardized TB risk assessment, training providers to use shorter LTBI treatment regimens, and use of a care coordinator. Chart abstraction to examine outcomes was conducted postintervention at 4 months. Results: In 2017, only 3 patients (7%) with LTBI were started on treatment. At 4 months postintervention, 28 (72%) patients with LTBI were started on treatment, of which 27 (96%) were placed on 3-to 4-month regimens. Conclusions:Training for providers and changes to clinic workflow, including use of a care coordinator, can help increase LTBI screening, testing, and treatment in community clinics.

Can Primary Care Drive Tuberculosis Elimination? Increasing Latent Tuberculosis Infection Testing and Treatment Initiation at a Community Health Center with a Large Non-U.S.-born Population

“…While there is little published data on LTBI testing and treatment practices in primary care health systems or clinics, meta-analysis data suggests that only 30% of people at risk for LTBI are started on treatment, and less than 20% complete appropriate treatment [ 14 ]. Prior studies done at community health centers (CHC) showed that adopting TB risk assessments, implementing provider education, and involving care coordination have increased LTBI testing and treatment completion; however, these studies generally took place over 1–2 years, with no follow-up [ 15 – 17 ]. The purpose of this retrospective data analysis was to describe LTBI testing and treatment practices during a series of quality improvement (QI) interventions at an urban CHC serving primarily non-USB Asian patients in the San Francisco Bay Area over a decade from 2010 to 2019.…”