Tuberculosis for Healthcare Providers
The Tuberculosis Program (TB) Program staff members provide expert consultation regarding contact investigation procedures, TB testing, recommendations and guidelines.
TB Reporting Requirements
NH statute RSA-141C and Administrative Rules HeP-300 require reporting of suspect or confirmed cases of tuberculosis disease within 24 hours and Latent TB Infection within 72 hours.
Reports can be called into the program or reported using the Communicable Disease Reporting Form.
Upcoming Events / Training Information
The NH TB Program offers various training programs and educational resources about TB and LTBI.
The four Tuberculosis Regional Training and Medical Consultation Centers (RTMCC) in the US offer a multitude of training opportunities and educational resources. New England's RTMCC, the Rutgers Global TB Institute, offers many programs throughout New England.
NH Reports / Statistical Information
New Hampshire is one of the lowest incidence states for TB in the nation, averaging 20 cases of active disease annually.
Reports of TB and LTBI are monitored throughout the state and reported to the CDC.
The highest risk factor for a TB diagnosis in NH is having been born in a foreign country where TB is commonly seen.
Information about TB in the communities you serve is available and can be used to conduct the annual risk assessment for your setting.
TB Financial Assistance Eligibility
Financial assistance is available for TB related care for patients who have no health insurance and a limited income. Only active TB cases and high risk LBTI (Latent Tuberculosis Infection) cases are eligible.
Reimbursement is made at the NH Medicaid rate directly to providers and pharmacies for TB-related visits, medications and laboratory testing. The TB Fund is always the payer of the last resort.
TB Laboratory Testing
The New Hampshire Public Health Laboratories offer free testing for suspect TB diagnoses. Tests offered include AFB smear, AFB culture, TB susceptibility and genotyping testing.
bacille Calmette-Guerin (BCG Vaccine)
There is no reliable method of distinguishing tuberculin reactions caused by vaccination with BCG from those caused by natural mycobacterial infections.
Consider large reactions to 5 US Units (TU) of Purified Protein Derivative (PPD) tuberculin in BCG-vaccinated persons as indicating infection with TB, especially among persons from areas with a high prevalence of tuberculosis.
Directly Observed Therapy (DOT)
DOT is defined as "observation of the patient by a health care provider or other responsible person as the patient ingests TB medications."
The Centers for Disease Control and the American Thoracic Society recommend that DOT be considered for all patients as one method of ensuring adherence to a medication regime. Patients who receive DOT can be placed on a thrice-weekly treatment schedule, generally after two weeks of daily treatment.
DOT includes the use of incentives and enablers to encourage adherence. Household members should not hold responsibility for DOT.
Additional Resources for Healthcare Providers