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Tuberculosis
 Screening and Treatment - Tuberculosis
Services provided to tuberculosis patients, suspects, contacts, and others at high risk include:
- Antituberculosis medication for treatment and prevention of disease;
- Outpatient examination and diagnostic services;
- Hospitalization for persons with tuberculosis who are very ill, require inpatient care, and have no source of payment;
- Laboratory services;
- X-ray services, if there is no source of payment;
- In-field, directly-observed therapy (DOT) for patients to complete recommended therapy;
- Contact examination and provision of preventive therapy to close contacts of infectious cases; and
- Preventive therapy for other high-risk tuberculosis skin test reactors.
Services are provided by State Health Department, county/municipal health departments and other contractors. Funding for tuberculosis control activities is provided through State funds, Federal Cooperative Agreement funds, and Federal block grant funds. In addition, county and municipal health departments receive funds under the Local Health Administration Law (Act 315) to include tuberculosis control services.
The number of tuberculosis cased in Pennsylvania decreased from 448 in 1998 to 336 in 2003, a 25% decrease. For 2003, there was a decrease of 4.8% in the number of cases reported from the previous year. The case rate per 100,000 population in Pennsylvania for 2003 was 2.7% as compared to a national rate of 5.1 cases per 100,000 population.
There were 3 cases of multidrug resistant tuberculosis in the Commonwealth (resistant to at least isoniazid and rifampin). However, 8.7% of the cases in Pennsylvania with known drug susceptibility results were resistant to isoniazid. In accordance with the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC) protocol, tuberculosis cases/suspects in areas with an isoniazid resistance rate of greater than 4.0% should be started and continued on four anti-tuberculosis medications until drug susceptibility results are obtained.
All tuberculosis cases/suspects in Pennsylvania should be started on a four-drug protocol.
Planned activities and services:
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Continued use of outreach workers to provide DOT to tuberculosis patients, 100% of new high-risk tuberculosis cases are treated using DOT within the State Health Districts. All County and Municipal Health Departments are required to abide by the DOT policy as a contractual stipulation for funding. When the policy went into effect, 51% of all tuberculosis cases received DOT. Of the cases reported in 2002, 59% received some or all treatment as DOT.
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Expanded and improved laboratory services allow for rapid identification of tuberculosis cultures and susceptibility results. Identification of tuberculosis can now be made in 4-5 hours for selected tuberculosis suspects. This allows the program to concentrate investigation efforts when most needed.
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Knowing the HIV status of tuberculosis patients is critical to ensure appropriate treatment and follow-up. As such, in accordance with the recommendations of the American Thoracic Society and the Centers for Disease Control and Prevention, all tuberculosis cases/suspects are pretest-counseled and encouraged to have HIV testing. In addition, all clinic attendees with positive tuberculin test reactions are pretest-counseled and encouraged to have HIV testing. The "Orasure" oral HIV test is available in all State Health Centers.
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Tuberculosis screening is offered to patients attending other state run clinics who may be at high risk for tuberculosis infection and to all individuals requesting HIV testing services.
The following reports are in PDF format. For more information regarding PDF format and Adobe Acrobat Reader click here.
Annual Reports
Fact Sheets
For additional tuberculosis information, check out the following websites.
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