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Tuberculosis (TB) Program
NOTICE: There is a Rifampin shortage (PDF).
The Tuberculosis (TB) Program provides support to local public health agencies, private physicians, and health care facilities involved in the screening, diagnosis, and treatment of Tuberculosis. The Program works to prevent transmission of TB through three strategies:
- By ensuring that infectious TB patients are appropriately treated until they are rendered and remain non-infectious.
- By ensuring that persons infected with TB who are not presently infectious remain non-infectious through the use of preventive drug therapy.
- By creating a community of health care providers knowledgeable in the diagnosis and treatment of TB infection and disease through the provision of educational programs across Kansas.
The Program provides medical consultation to health care providers, technical support to local health officials in conducting effective contact investigations, and
anti-tuberculosis medications to patients through the health professionals treating patients with TB infection or TB disease. The program also maintains surveillance on the incidence of TB in Kansas to identify populations at increased risk for the disease.
Reporting Requirements & Resources
Disease Reporting Requirements
State laws and regulations require that cases of tuberculosis be reported to the local or state health department. The TB Program provides anti-tuberculosis medications to local health departments and medical providers for the treatment of TB disease. Additionally, preventive medications for individuals with TB infection are provided to local health departments or other medical providers.
In order to receive medications for a patient afflicted with TB infection, the health care provider or local health department must provide the state program information about the diagnostic screening of the patient (skin or blood test and chest x-ray results). For individuals with active TB disease, the local health department must provide information about the diagnostic screening of the patient along with information about the patient's treatment, potential contacts to the patient and other detailed information as requested on an ongoing basis.
Resources for Health Care Providers & Patients
- CDC Dear Colleague Letter
- Think, Test, Treat TB website
- TB Resources for Health Care Providers
- TB Resources to Share
- What You Need To Know About the TB Skin Test
- TB Screening and Testing of Healthcare Personnel
Additional Resources
What is Tuberculosis?
Tuberculosis (TB) is a serious disease caused by a type of bacteria that can be spread from person to person through the air. A person with TB disease spreads the bacteria by coughing, laughing, sneezing, or speaking. TB is most commonly spread to others in confined, poorly ventilated spaces. Although anyone can be exposed to this disease, certain individuals are at higher risk for exposure, including health care professionals, the homeless, and people who were born in countries with high TB rates. Elderly people and individuals with HIV or AIDS are also more likely to get TB because their bodies are less able to fight off infections.
TB Infection or TB Disease
Being diagnosed with TB infection, also called Latent TB Infection, Latent TB, or LTBI, means you have inactive TB bacteria in your body. Because the bacteria are inactive, you are not contagious; however, TB infection may become an active disease if your immune system is weakened, which includes if you are elderly or if you have a condition such as HIV. According to the World Health Organization, about 1/4 of the world's population has TB infection.
Being diagnosed with TB disease, also known as Active TB or Active TB disease, means you have active TB bacteria in your body. Usually, a person with Active TB Disease exhibits symptoms such as a lasting cough, coughing up blood, fatigue, fever, loss of appetite, and weight loss. If you have TB disease, the bacteria are multiplying in your body and can be spread to others. TB disease can almost always be cured, but it may be fatal if you don't take all your medication. Treatment for TB disease typically consists of multi-drug therapy for an average of six months.
Diagnosing TB
In addition to using symptoms and chest x-rays to help diagnose TB disease, sputum specimens (material coughed from deep within the lung) are sent to the Kansas Division of Health and Environmental Laboratories for microscopic examination and culture to detect and recover the TB bacterium and confirm the diagnosis. The TB bacteria grown in culture are tested against the antibiotics used to treat the disease to make sure the bacteria are sensitive to them. The laboratory also uses the newer TB gene amplification tests on microscopically positive sputum specimens to identify TB within one to two days. This is very helpful since TB bacteria grow slowly and take an average of 16 days to grow in culture but can take up to six weeks to grow. However, it's still important to grow the bacteria in culture for antibiotic sensitivity testing even if the gene amplification test is positive.
TB in Kansas
Incidence Rate
The incidence rate for tuberculosis in Kansas for 2020 was less than two cases per 100,000 persons - approximately half the national U.S. rate, and a mere fraction of the historic rate. However, the program is now seeing a rise in the number of cases. Despite severe state budgetary challenges and the rippling effects of the COVID-19 Pandemic, the Kansas Legislature has assured that the state will continue funding medications for program clients, regardless of cost. Most significantly, Kansas has already met Healthy People 2030 goals for decreasing the rate of new TB cases per 100,000 people. The program is striving to maintain this positive momentum as it works towards the World Health Organization's Sustainable Development Goals including ending the global TB epidemic by 2030.
Improvement Goals
By July 2024, the program plans to improve its testing, surveillance, and prophylactic treatment completion rates for infection, particularly among case contacts and
high-risk groups. Local health department staff will be trained in an established standardized case investigation protocol. Updates and maintenance of this protocol, an annual training and education plan, and Web-based reporting forms will be part of this effort. Health departments across the state will submit all tuberculosis information electronically and the Program will begin electronic infection reporting to the Centers for Disease Control and Prevention.
Challenges
The Kansas Tuberculosis Program will also confront several unique challenges over the next five years. Increased involvement with local district attorneys, city councils, county and state legislatures is anticipated to encourage the prioritization of and investment in public health. As the Kansas population continues to diversify, the need for culturally competent skills and cross-culturally informed staff will become ever more crucial. Drug research is ongoing to produce medications with reduced side effects.
As public health enters the third decade of the 21st century, the Kansas Tuberculosis Program is poised to deliver services and interventions to further protect and enhance the health of Kansans.
Program Mission, Values & Global Elimination Efforts
The mission of the Kansas Tuberculosis (TB) Program is to protect and improve the health of all Kansans through an emphasis on accountability, active intervention, and prevention of TB. This mission drives the Program to achieve the national and global goal of TB elimination. Knowledge, commitment, teamwork, sense of direction, fiscal responsibility, and customer service are the hallmark values of the Kansas Tuberculosis (TB) Program. With the help of innovative solutions for medication inventory management and record-keeping, the Program now provides medications for nearly 90 percent of Kansas cases, regardless of health insurance status.