Marijean Day BScN, RN -- TB Control: BCCDC

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TB Control BCCDC

• Marijean Day, RN
• Field Operations Nurse
• March 22, 2012

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Objectives

• TB Epidemiology
• TB Control, Clinical Prevention Services, BCCDC
• Research Special Projects
• TB Strategic Plan

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BC TB Epidemiology 2011

• 266 active cases in 2011
• 172 pulmonary
• 74 extra-pulmonary only
• 20 pulmonary extra pulmonary
• 15 CNS or miliary
• Cluster of 6 2010/11in Prince George

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Figure 1 Tuberculosis incidence rates by Health
Authority in BC at the time of diagnosis,
2005-2008
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Tuberculosis incidence rates per 100,000 by
birthplace and year, 2001-2010, B.C.
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TB HIV Co-Infection

• small s of co-infected
• 2011-2012 cluster in northern community

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Site of Tuberculosis, 2005-2010, B.C.
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Type of Drug Resistance 2005-2008
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TLTBI

• Highest proportion TLTBI between 40-59
• Females 58 of clients over 4 years

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TB Control Programs

• TB Clinics
• Downtown Eastside
• New Westminster
• Vancouver
• Victoria
• TB Programs
• Contact Tracing
• DOT Program
• Field Operations
• TB Services for Aboriginal Communities (TBSAC)

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BCCDC Org Chart
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Lower Mainland

• Contact Tracing
• 2 RNs
• Supports FHA VCH
• Liaise with local hospitals
• 10 physicians service TBC

• DOT Program
• VTBC, NWCC, DTES
• 2 RNs
• 2 Outreach Workers

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PHNs CHNs Provincially

• Field Operations
• 1 RN
• Telephone consultation for rest of the province
  and the Yukon
• Facilitates Provincial Working Group
• Site Visits PRN

• TBSAC
• 1 Respirologist
• 3 RNs
• 2 Nurse Consultants
• 1 Nurse Educator
• Community Visits
• 5 Annual Workshops

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Educational MaterialsHealth Care Professional
Patients
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TB Surveillance

• iPHIS Database
• CPS Surveillance Team
• Epidemiologists
• Data Analysts
• Panorama
• BC-Yukon Project
• First Nations Panorama Implementation Project

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BCCDC Provincial Pharmacy

• Free TB medications
• TLTBI
• Active TB Tx
• Rx initiated by TBC physician
• Meds couriered daily
• VTBC
• Patients seen by pharmacist

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TB/Mycobacteriology LabBCCDC Public Health
Microbiology Reference Lab

• Microscopy
• Culture
• MGIT
• Lowenstein-Jenson agar
• Molecular
• daily PCR testing on AFB smear-positive specimens
• AccuProbe 2x/week on culture
• DSTs
• Genotyping

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Special Projects

• Genomics research
• Cell phone
• RCT collaboration
• Field Epidemiologists

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Operational EvaluationiMPROVE

• Operational processes reviewed via the iMPROVE
  process with RPIWs
• Successful Outcomes
• Decreased patient wait times in clinic
• Decreased paper-trail
• Contact tracing program

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BC TB Strategy

• To be released Spring 2011
• Collaboration with a broad range of stakeholders
  throughout the province in 36 intensive sessions
• Aligned with Canadian TB Strategy First Nations
  Inuit Health

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Summary

• Innovation
• Integration
• Improve health in BC by reducing TB its effects
  based on best evidence in a culturally competent
  manner