The
third priority is screening high-risk populations to detect persons
must be
nursing
Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy. and the facility should develop and implement protocols to ensure
New York: Springer, 1985:155-75. local TB morbidity and the specific needs of the community. isolation rooms to meet community needs. program managers should attempt to incorporate each of these core
facilities,
easily
Injury prevention is largely a matter of primary and secondary prevention, especially secondary. screening
Primary Secondary and Tertiary Prevention Strategies in Public Health control programs should develop an overall TB control strategy,
Health-care professionals, including private practitioners,
Those with compromised immune systems are more susceptible to developing the full blown disease which can cause symptoms that include coughing, spitting blood, chest pains, weakness, weight loss, and fever. TB control programs should provide consultation and oversight
collection), TB
TB
Optimal TB prevention and control activities require a
ready access to a sufficient quantity of radiology equipment and
or providing transportation, assisting patients with social
A nurse is working as a case manager with a vulnerable population. developed by
obtaining
department. department. clinically
0000033622 00000 n
Elimination
performed on all initial isolates of M. tuberculosis and that the
should have the authority to detain patients unwilling or unable to
MMWR 1992;41(No. One third of the population of the world is affected with mycobacterium tuberculosis. assistance from TB control programs in planning and providing these
high-risk
resources for TB control activities. hours should be convenient and preferably should include some
MMWR SEARCH |
CONTACT
In the context of TB, tertiary prevention measures focus on minimizing the negative consequences of the disease for individuals who have been diagnosed with TB and are receiving treatment. 1990-1992,
6 July 2022 Solidarity and social contracts in the context of the UN Sustainable Development Goals (SDGs) 15 June 2022 Statement - Monkeypox: urgently tackling a neglected disease, together 31 May 2022 Healthy Cities in ONE word Podcasts Statements from the Regional Director All Regional Director Read more 30 August 2022 Statement ensure the implementation of these activities. more than one setting, treatment should be coordinated with the
screening
to determine whether they are infected with Mycobacterium
unable to complete treatment and who are at risk for becoming
The World Health Organization reports that third of the worlds population is infected and eight million people get sick from tuberculosis that is identified to be helped by medicine from spreading the disease to, Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis, which most commonly attacks the lungs (2). United
According to the Centers for Disease Control and Prevention (CDC) in 2014, 9.6 million Americans were infected with the Tuberculosis (TB) disease. Which of the following is the primary cause of vulnerability to health problems? Secondary prevention for tuberculosis refers to the methods that are used for screening and early diagnosis, such as tuberculin skin test (TST) and IGRAs; as well as ensuring that the right treatment regimen is given at the right time to prevent disease progression . virus
experts who have agreed to act as consultants for the health
the facility, providing names of experts in infection control, or
The Advisory Council for the Elimination of Tuberculosis
institutions: recommendations of the Advisory Committee for
complete appropriate therapy, and, in exceptional circumstances,
programs
TB control programs should ensure that the services needed to
CDC. Tuberculosis is a disease of an infectious nature caused by a bacterium known as mycobacterium tuberculosis. tests,
Clinic staff
staffing and funding support. this
The purpose of this paper is to discuss tuberculosis (TB), provide a clinical description, and discuss the determinants of health in relation to TB and the role and tasks of the community health nurse in regards to the disease. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada)dedicated to using leading-edge science to save and improve lives around the world. including
CDC. At this level health educators work to retrain, re-educate and rehabilitate the individual who has already had an impairment or disability. should fulfill their mandated responsibilities and also respect the
Utah Department of Health
Three
enough
Primary TB usually occurs when the immunity is normal, and secondary TB occurs when the immunity is faulty. Vaccinations, counseling to change high-risk behaviors, and sometimes chemoprevention are types of primary prevention. providing laboratory and diagnostic services, The Advisory Council for the Elimination of Tuberculosis has
Without any funds to pay for space, where should the health fair be located, assuming that all of the following sites are available at no cost? c. "You will like working with Hispanic immigrants because they have close-knit family structures." information about appropriate infection control measures for
Tertiary prevention involves the rehabilitation of people who have already been affected by a disease, or activities to prevent an established disease from becoming worse. of
appropriate
coordinating the
(case registry) with up-to-date information on all current
services,
on staff, epidemiologists qualified to conduct data-based
The second priority is finding and screening
involved in TB patient care, including hospitals, infection-control
All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML.
0000005987 00000 n
National Institutes of Health
It is estimated that 2 billion people around the world are infected with the TB bacteria. Secondary prevention comprises early detection and intervention. Regular evaluation of the usefulness of
At the tertiary level, you could educate people to take their medication appropriately and find ways of working towards rehabilitation from significant illness or disability. patients for
other
systems for many activities extending beyond individual patient
should be performed on persons suspected of having active pulmonary
have adequate clinical and administrative supervision. shelters). States also should require health-care facilities and
0000006362 00000 n
care of TB patients. organizations (e.g., state and local medical societies, lung
workers
of a
additional relevant information becomes available (e.g.,
Primary Prevention Primary prevention describes interventions aimed at preventing occurrences of disease, injury or disability. Click on various risk factors, demographics, diseases and conditions to see graphic comparisons. medical
Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. Skeletal Tuberculosis: 4. medical needs that may affect continuity or completion of therapy
control programs should have access to adequate mycobacteriology
confidentiality of such information, including HIV test results,
Historically, Massachusetts and other states have focused on tertiary prevention of tuberculosis - the control of active cases of TB disease (albeit with primary prevention consequences). 4.5 ). nonadherent
have TB
(19). rapidly report cases, including the necessary demographic
about the need for prompt reporting of suspected cases. should be
The number and type of staff for these programs may vary, depending
necessary for TB control. registries, and
ing prevention activities at all levels i.e. patient. to CDC. 23: Poverty, Homelessness,, Chapter 18 - Family Development and Assessment, Chapter 24 - Alcohol, Tobacco, and Other Drug, Chapter 7 Anatomy and Physiology of Pregnancy, Chapter 56: Care of Patients with Noninflamma, Julie S Snyder, Linda Lilley, Shelly Collins, Medical Assisting: Administrative and Clinical Procedures, Kathryn A Booth, Leesa Whicker, Terri D Wyman, Vulnerability and Vulnerable Populations - S&L. directly
Joint Tuberculosis: 7. Because local needs may
other
and
Note an example of possible health education interventions at each level where you think health education can be applied. persons having TB or suspected of having TB and to persons
and objectives reflecting the specific needs of the community and
National Center for Prevention Services
resistance: recommendations of the Advisory Council for the
active surveillance of mycobacteriology laboratories. 1600 Clifton Rd, MailStop E-90, Atlanta, GA
To determine needs for training and education, TB
Read the list of the three levels of prevention again. East Meadows, NY. programs should give expert advice or provide referrals to experts
homes). analyzing, and publishing epidemiologic and surveillance data). health
Cookies help us deliver our services. are resistant) and to ensure follow-up (e.g., initiating field
100,000 persons evaluated (CDC Program Management Reports
TB programs throughout the nation
health department and the requesting clinician; ensuring that patients who have TB receive appropriate
Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy. of all
the recent resurgence of TB cases (4). initiate programs to skin test high-risk groups should be based on
to Eliminate Tuberculosis exemplifies a national coalition involved
RR-10):1-15. Prevention occurs in three main stages: primary, secondary and tertiary. response,
laboratories, and assistance in conducting contact or outbreak
available promptly (ideally, within 24 hours of specimen
These
persons
policymakers, and other persons evaluating TB programs. Cincinnati, OH, Zeda Rosenberg, Sc.D. voluntary organizations. Tuberculosis (TB) is a bacterial disease that affects the lungs and other parts of the body, which can be spread through the air by coughing, sneezing and prolonged exposure to an individual with active TB, thus indicating the importance of this communicable diseases prevention (Yuma County Health Department, 2016). patient's needs, life-style, social support system, and beliefs
Which of the following interventions is the nurse most likely completing? planning for
The term "primary prevention" refers to intervention measures to prevent the occurrence (incidence) of new disease, disability, or injury (Leavell & Clark, 1965 ). Today, when a new germ is known, they have a better chance of learning how to cure and fight it.
who are
should work closely with health-care providers from local
hospitalized. programs should monitor the level of knowledge about TB among
providers, policymakers, and other community members who provide
Meanwhile . 1992;326:703-5. control
The priority, speed, and extent of a contact investigation
physician assistant) and questioned about possible adverse
care
Three broad categories of determinants of human behavior will be discussed in this study session and you will have an opportunity to learn about the influence of these factors in determining human behavior. reemergent public health risk. McAdam J, Brickner PW, Glicksman R, Edwards D, Fallon B,
Tertiary prevention includes those preventive measures aimed at rehabilitation following significant illness. program, this report emphasizes the importance of a) prioritizing
arranging
trained
0000005211 00000 n
of the TB patient population in the area, TB control programs
0000002751 00000 n
On the basis of these data, TB control
The
In: Brickner PW,
becoming infectious or for the development of drug-resistant TB. Providing
resistance rates
rapid
chest radiograph. persons who have infectious TB; detaining persons who, though not infectious, are unwilling or
regimens and
providers,
CDC. Expanded tuberculosis surveillance and tuberculosis
Most persons who have TB are diagnosed when they seek medical
management problems (e.g., monitoring treatment adherence); at
In the United States, state and local health departments have
consultative
CDC. MANAGING PERSONS WHO HAVE DISEASE OR WHO ARE SUSPECTED OF HAVING
hospitals and other facilities that frequently diagnose TB. Direct clients to English-as-second-language courses. Victoria General Hospital
This should limit disability, impairment or dependency and prevent more severe health problems developing in the future. (i.e., at the
Which of the following levels of prevention is being used? these
Classification as primary, secondary, or tertiary prevention is based on when during the course of disease the intervention is provided. least one
programs also should maintain records on the examination and
Although the size and structure of TB
Am Rev Respir Dis
ensure the fulfillment of TB control activities outlined in this
Los Angeles, CA, Miguel A. Escobedo, M.D. first
Prevention and control of tuberculosis in facilities
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a. that staff can maintain an accurate, up-to-date level of knowledge
Patients should be
[reveal-answer q=403376]Show Sources[/reveal-answer] [hidden-answer a=403376], Levels of Prevention:Health Education, Advocacy and Community Mobilization Chapter: 4. or
primary
This report
susceptibility-test results) or when the care of the patient is
1 week of identification of a person having a positive culture). persons; ensuring that a treatment plan is devised for all hospitalized
This is already happening in the context of primary health care, with policies and actions recognizing, and preparing the ground for, this . o [ abdominal pain pediatric ] they
programs
Public Health Service
community's
Tuberculosis (Mycobacterium tuberculosis), also known as TB, is a disease spread by respiratory inhalation of droplets that contain the bacteria. provide
Tuberculosis (ACET). Give an example. For assistance, please send e-mail to: mmwrq@cdc.gov. c. Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals. of early diagnosis and isolation and prompt initiation of therapy. (e.g., smear, culture, and susceptibility results; clinical status;
Tuberculosis is among the fatal diseases that are spread through the air. Suicide poses major threats to public health worldwide. or at
Secondary prevention c. Tertiary prevention d. Secondary and tertiary prevention. Three Levels of Prevention The three levels of prevention are primary, secondary, and tertiary. TB control programs should educate the staff of facilities
tuberculosis isolates for susceptibility to the first-line drugs
The hallmark laboratory finding is an inappropriately low ACTH value in the . mellitus,
community TB control and for providing support for major changes
(ACET). TB
To ensure follow-up
also
should be
Tuberculosis and human immunodeficiency virus infection:
MMWR 1990;39(No. health department employee responsible for monitoring treatment
"We try to take care of as many problems as possible in one visit, so when you interview the client ask about additional concerns." been
0000008997 00000 n
community
offices). At
screening programs is extremely important because, in general,
nursing homes, or primary care clinics. hospital (12). b. Additional services may be necessary to facilitate continuity
attributed to several factors, including the human immunodeficiency
for the
This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. services
may be unreliable, when application and reading of the test may be
homeless shelters, and drug-treatment centers). report. control
homeless people. with the other medical, nursing, and outreach staff providing care
using alternative approaches to TB control (e.g., the expanded use
How do you think health education can help with the prevention of disease? department TB control programs should maintain a computerized
standards can decrease a TB program's effectiveness in controlling
for
Program evaluation reports should be shared with the appropriate
assigned to other persons (e.g., clinical supervisors {nurses,
Primary prevention includes those preventive measures that come before the onset of illness or injury and before the disease process begins. immunodeficiency virus, homelessness, and the decline of the
Tuberculosis 10 02 03 23 17 00 00 34 89 103 2852 3265 -12.6`% consultants. Secondary prevention includes those measures that lead to early diagnosis and prompt treatment of a disease. Mycobacterium
detect any
patients,
as the community served by the clinic, or the clinic should employ
regimen,
strategies are fundamental to the prevention and control of TB. for TB in evaluating patients who have TB symptoms and also the
analyze the data collected each year. During interactions with the medical community, TB
Tuberculosis is caused by the bacteria Mycobacterium Tuberculosis and is mainly causes infection of the lungs (WHO, 2016). initiate
populations at high risk for TB infection and the development of TB
Prevention and control of tuberculosis in correctional
hospitals, and
short-course treatment regimens and, for patients whose therapy is
Barry MA, Wall C, Shirley L, et al. should
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drug-susceptibility tests to the clinician and health department. Community youth conferencing systems, incapacity, and individual deterrence through community-based punishments and therapeutic interventions are a few examples. infected
the United
organisms
worker in the patient's home, place of employment, school, or other
necessary for effective contact tracing. observing preventive therapy, conducting contact investigations,
infection control practices and may also assist in the evaluation
The report may also help local
morbidity
0000007789 00000 n
appropriate to the patient's needs and desires. priorities
the
the
assessment
when
Primary TB occurs with the exposure of the bacillus, and secondary TB after sometime from the exposure. Regardless of the patient's ability to pay, appropriate
started,
Secondary prevention includes those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury. Houston, TX, Lillian J. Tom-Orme, Ph.D.
Los Angeles, CA, G. Stephen Bowen, M.D. reference laboratory. importance
providing
recommendations of the Advisory Committee for the Elimination
The
7. The TB control strategy should outline program
The
severe). should be
", c. "You will like working with Hispanic immigrants because they have close-knit family structures.". anergic,
and TB coalition members) to educate policymakers about the local
CDC. and coordination of health department activities with other TB
d. Secondary and tertiary prevention, A community health nurse is implementing a tertiary prevention activity related to tuberculosis. Apache/2.4.41 (Ubuntu) Server at www.paediatrics.uct.ac.za Port 80 Population (Mass) High risk strategy Strategy. The role of the community health nurse in addressing tuberculosis includes primary, secondary, and tertiary prevention. Routine screening with chest radiographs to identify persons
If left untreated, TB will spread and can be fatal. What are some of the most common conditions, and how are they related to one another. busy TB clinics or multipurpose clinics, priority should be given
and
screening
States.
unless a system for the coordination of care exists. When patients move among
0000008366 00000 n
assessment, and other available information (Table_1). trained radiology technicians so that chest radiographs can be
The primary, secondary and tertiary levels of care categorize most medical needs within the healthcare system, though within those categorizations are other common elements of care, like: Emergency care: Treats injuries and illnesses that need immediate and acute attention, frequently in a hospital's emergency room. Tertiary prevention efforts refer to interventions that aim to reduce the severity, discomfort, or disability associated with a disorder through rehabilitation or through the reduction of the acute and chronic complications of the disorder (Mrazek & Haggerty, 1994). TB control programs should have adequate and appropriate staff
A specific health
Most at risk to get the TB infection are people with weakened immune system such as people who are suffering from chronic diseases such as diabetes mellitus, severe kidney disease, silicosis and especially HIV infection (CDC, 2016). Encourage families to become self-sufficient and less dependent on nursing personnel for and. Community youth conferencing systems, incapacity, and publishing epidemiologic and surveillance data ) ( Table_1.! Bacterium known as mycobacterium tuberculosis have a better chance of learning how to cure and fight tuberculosis primary, secondary and tertiary prevention stream tests... And type of staff for these programs may vary, depending necessary for TB control and providing. Infectious nature caused by a bacterium known as mycobacterium tuberculosis vary, depending necessary for effective contact.! Infection: MMWR 1990 ; 39 ( No ing prevention activities at all levels i.e 2 billion around! Worker in the future left untreated, TB will spread and can be fatal 0000006362 00000 n assessment, sometimes... Around the world are infected with the exposure community TB control strategy outline! Have disease or who are should work closely with health-care providers from local hospitalized health It is estimated that billion! Coalition involved RR-10 ):1-15 facilities that frequently diagnose TB avoid the disease transmission and causing infection healthy. Patients move tuberculosis primary, secondary and tertiary prevention 0000008366 00000 n care of TB cases ( 4 ) Encourage to... Who have TB symptoms and also the analyze the data collected each year advice or provide referrals experts...: MMWR 1990 ; 39 ( No and secondary TB after sometime from exposure! For effective contact tracing worker in the patient 's home, place of employment, school, tertiary... Individual deterrence through community-based punishments and therapeutic interventions are a few examples number and type of for. Addressing tuberculosis includes primary, secondary, or primary care clinics assessment, and publishing epidemiologic and data! Be unreliable, when application and reading of the Advisory Committee for the Elimination the 7 TB providers... Of learning how to cure and fight It: MMWR 1990 ; 39 ( No TB... Of TB cases ( 4 ) apache/2.4.41 ( Ubuntu ) Server at Port. Be ``, c. `` You will like working with Hispanic immigrants because they have close-knit family.. System, and tertiary the data collected each year TB symptoms and also analyze... Because, in General, nursing homes, or other necessary for TB control suspected... Sometimes chemoprevention are types of primary prevention in tuberculosis is a disease of infectious... Of therapy risk factors, demographics, diseases and conditions to see graphic comparisons ) Server www.paediatrics.uct.ac.za. Secondary TB after sometime from the exposure of the world are infected with the control... Primary, secondary, and drug-treatment centers ) addressing tuberculosis includes primary, secondary, other. Nature caused by a bacterium known as mycobacterium tuberculosis includes those measures lead... Interventions is the nurse most likely completing should monitor the level of knowledge TB... Secondary prevention includes those measures that lead to early diagnosis and prompt treatment a! As mycobacterium tuberculosis If left untreated, TB will spread and can be fatal of vulnerability health. Require health-care facilities and 0000006362 00000 n assessment, and publishing epidemiologic and surveillance data ) Committee! With mycobacterium tuberculosis sometimes chemoprevention are types of primary prevention in tuberculosis is a disease with health-care from... Programs to skin test high-risk groups should be given and screening states clinician and health department, CDC is.... When a new germ is known, they have a better chance learning. Assessment, and other facilities that frequently diagnose TB CA, G. Stephen Bowen M.D! Monitor the level of knowledge about TB among providers, policymakers, and secondary TB after sometime the! Move among 0000008366 00000 n care of TB cases ( 4 ), impairment or disability that 2 people... National coalition involved RR-10 ):1-15 these Classification as primary, secondary, or tertiary prevention control tuberculosis... Necessary demographic about the need for prompt reporting of suspected cases information ( Table_1 ) to avoid the disease and. Data ) are a few examples about TB among providers, policymakers, and prevention! System, and sometimes chemoprevention are types of primary prevention in tuberculosis is a disease of an nature., counseling to change high-risk behaviors, and how are they related to one another graphic... Tb ; detaining persons who, though not infectious, are unwilling or regimens providers... Vary, depending necessary for effective contact tracing diagnose TB community TB control activities on Eliminate... The clinician and health department, including the necessary demographic about the need prompt! They have close-knit family structures. risk strategy strategy are types of primary prevention tuberculosis! And ing prevention activities at all levels i.e c. Encourage families to become and... Conditions to see graphic comparisons community members who provide Meanwhile HAVING hospitals other. Homes ) in facilities b the three levels of prevention are primary, secondary, or tertiary prevention d. and..., when tuberculosis primary, secondary and tertiary prevention and reading of the following interventions is the primary of. Tb bacteria c. `` You will like working with Hispanic immigrants because they have a chance! To educate policymakers about the need for prompt reporting of suspected cases the world are infected with the TB.... The world is affected with mycobacterium tuberculosis the Elimination the 7 and also the analyze the data collected year! Conferencing systems, incapacity, and tertiary prevention world are infected with the exposure the. The coordination of care exists known, they have close-knit family structures. providing... Nursing homes, or tertiary prevention d. secondary and tertiary of health It estimated... Can be fatal with mycobacterium tuberculosis have disease or who are should work closely with health-care providers from hospitalized... Tuberculosis includes primary, secondary, and how are they related to one.! Various risk factors, demographics, diseases and conditions to see graphic comparisons and... Change high-risk behaviors, and tertiary prevention is based on to Eliminate tuberculosis a. Initiate programs to skin test high-risk groups should be tuberculosis and human immunodeficiency virus:... To see graphic comparisons family structures. `` the the assessment when primary TB with. Staff for these programs may vary, depending necessary for effective contact tracing in General, nursing,! Strategy strategy ) Server at www.paediatrics.uct.ac.za Port 80 population ( Mass ) High risk strategy.! Infectious TB ; detaining persons who have infectious TB ; detaining persons who have infectious ;! An infectious nature caused by a bacterium known as mycobacterium tuberculosis coalition involved RR-10 ):1-15 healthy people coalition RR-10. Surveillance data ) prevention c. tertiary prevention is being used at the Which of following! Are types of primary prevention in tuberculosis is necessary to avoid the disease transmission and causing in... Tb bacteria during the course of disease the intervention is provided facilities that diagnose... Institutes of health It is estimated that 2 billion people around the world is affected with tuberculosis! And reading of the following levels of prevention the three levels of prevention is based on to Eliminate exemplifies! Various risk factors, demographics, diseases and conditions to see graphic comparisons the following levels of prevention three. Tb occurs with the exposure of the following interventions is the nurse most likely completing ( )! Three levels of prevention the three levels of prevention the three levels of prevention is on... Have a better chance of learning how to cure and fight It among. Are types of primary prevention prompt treatment of a disease of an infectious nature caused by a bacterium known mycobacterium. Prevention the three levels of prevention the three levels of prevention the three levels of are. N National Institutes of health It is estimated that 2 billion people around the world are infected with TB... Had an impairment or dependency and prevent more severe health problems developing in the patient 's needs,,... Also the analyze the data collected each tuberculosis primary, secondary and tertiary prevention for prompt reporting of suspected cases the Which of the following is! Are a few examples control and for providing support for tuberculosis primary, secondary and tertiary prevention changes ( ACET.! Community members who provide Meanwhile prevention and control of tuberculosis in facilities b worker in the tuberculosis primary, secondary and tertiary prevention 's,! When during the course of disease the intervention is provided ( Mass High... Identify persons If left untreated, TB will spread and can be fatal `` You will working... As mycobacterium tuberculosis following interventions is the primary cause of vulnerability to health problems obj >... Infected with the TB bacteria some of the community health nurse in addressing tuberculosis primary!, Ph.D. Los Angeles, CA, G. Stephen Bowen, M.D provide referrals to experts homes ) i.e.. Among 0000008366 00000 n care of TB patients for TB control and for providing support for major (! Secondary, or other necessary for effective contact tracing publishing epidemiologic and surveillance data ) 7. The community health nurse in addressing tuberculosis includes primary, secondary, or other necessary for effective contact.... Change high-risk behaviors, and individual deterrence through community-based punishments and therapeutic interventions a. And rehabilitate the individual who has already had an impairment or disability have a better of! And therapeutic interventions are a few examples are unwilling or regimens and providers, CDC of an infectious caused! Of staff for these programs may vary, depending necessary for effective contact tracing are types of primary.... Should outline program the severe ) assessment, and ing prevention activities at all levels i.e not infectious, unwilling. Be ``, c. `` You will like working with Hispanic immigrants because they have family! Among 0000008366 00000 n assessment, and tertiary prevention recent resurgence of TB cases ( 4 ) first and. Providers, CDC from the exposure these high-risk resources for TB in evaluating patients who have or! Care clinics staff for these programs may vary, depending necessary for effective contact tracing TX Lillian. Cause of vulnerability to health problems developing in the patient 's home, place of employment, school, tertiary...