A positive result in contacts with minimal exposure is more likely to be the result of an old infection or nonspecific tuberculin sensitivity (46).
Whenever the contact's exposure to the index TB patient has occurred <8--10 weeks necessary for detection of positive skin tests, repeat testing 8--10 weeks after the most recent exposure will help identify recent skin test conversions, which are likely indicative of recent infection.For optimal efficiency, priorities should be assigned to contacts, and resources should be allocated to complete all investigative steps for high- and medium-priority contacts.
The interviewer might need to spend more time asking regarding contacts who are difficult for the patient to remember.
The investigator must constantly balance available resources, especially staff time, with expected yield.
Details regarding employment, hours, working conditions, and workplace contacts should be obtained during the initial interview with the index patient (see Investigating the Index Patient and Sites of Transmission), and the workplace should be toured after accounting for confidentiality and permission from workplace administrators or managers.
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If the interviewer senses resistance to meeting in certain places or discussing those places, making site visits to those places might facilitate identification of additional contacts whom the index patient had not remembered or wanted to name.Proxy InterviewProxy interviews can build on the information provided by the index patient and are essential when the patient cannot be interviewed.
Data regarding high- and medium-priority contacts inform this decision.Communicating through the media.
Therefore, the recommendations (Appendix B) have not been rated by quality or quantity of the evidence and reflect expert opinion derived from common practices that have not been tested critically.These guidelines do not fit every circumstance, and additional considerations beyond those discussed in these guidelines must be taken into account for specific situations. remote desktop connection password crack
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Outbreak of tuberculosis associated with a floating card game in the rural south: lessons for tuberculosis contact investigations.
In addition to its simplicity and intuitive appeal, an advantage to this approach is that contacts with less exposure are not sought until evidence of transmission exists.
Contacts who have received a diagnosis of infection attributed to MDR TB should be monitored for 2 years after exposure; guidelines for monitoring these contacts have been published previously (6).Adherence to TreatmentOne of the national health objectives for 2010 is to achieve a treatment completion rate of 85% for infected contacts who start treatment (objective no.
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