Introduction The Centers for Disease Control and Prevention (CDC) and American Thoracic Society (ATS) issued revised guidelines for targeted tuberculin testing and the treatment of latent tuberculosis infection (LTBI). The guidelines were published in the June 9, 2000 issue of the Morbidity and Mortality Weekly Report (MMWR) and in the American Journal of Respiratory and Critical Care Medicine (2000;161:S221–S247). In addition to changes in treatment and monitoring recommendations, an emphasis was placed on testing only those who may have recently been infected with tuberculosis (TB) and those at risk for progression from latent infection to active disease. This slide set includes the recommendations in the 2000 guidelines and updates to the recommendations published before November 2004. Key areas covered in this slide set include: • Brief history of LTBI treatment • Concept of targeted testing • Risk factors for LTBI • Tuberculin skin testing and QuantiFERON®-TB Test • Treatment recommendations for LTBI • Case studies Target audience: The target audience for this slide set is the primary healthcare provider. Supporting references and resources have been included in the slide set. Adapting the presentation: The slide can be used in its entirety or in sections depending on audience needs. If the slides are altered, the CDC and HHS logos must be removed. Use of case studies: The slide set contains three case studies to reinforce the importance of targeted testing and the identification individuals at risk for LTBI. The case study slides may be incorporated at the presenter’s discretion. The question and answer slides following the case slides can be used to encourage group participation and discussion. Alternatively, the presenter can present the cases and highlight the main educational points without group discussion.
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Relative risk of developing active TB for persons with certain clinical conditions: Silicosis 30 times greater Diabetes 2-4 times greater Chronic renal failure/hemodialysis 10-25 times greater Gastrectomy 2-5 times greater Jejunoileal bypass 27-63 times greater Kidney transplant 37 times greater Heart transplant 20-74 times greater Cancer of head/neck 16 times greater