About Us
The Tuberculosis (TB) and Hansen's Disease Unit (TB Unit) administers TB program services statewide per Texas Health and Safety Code Chapter 31, Primary Health Care by allocating funds to local and regional health departments across the state to perform TB prevention and care activities.
The TB Unit establishes core elements to design a funded TB program, prepares and maintains standards of care, and develops methods to deliver appropriate services. The TB Unit provides laboratory support, medications, testing supplies, courier transport, nursing, and medical consultation services to funded TB programs to enhance service delivery capacity.
The activities performed at the state, regional, and local levels support our vision and mission:
Vision
A Texas free from tuberculosis.
Mission
To eliminate tuberculosis as a public health threat.
These activities are outlined in the Texas Health and Safety Code, Chapters 81 and 89. They detail the importance of identifying and reporting tuberculosis to the public health system.
Services We Provide
DSHS provides contractual support and technical assistance to the following areas:
- Thirty local health departments to maintain TB programs
- Eight public health regions to maintain TB services
- Four binational TB programs to support prevention and care along the Texas/Mexico border
- Consultation is available from DSHS - Recognized Tuberculosis Medical Consultants
Core Program Functions
| Surveillance | Epidemiology | Clinical Care Services | Continuing Quality Improvement |
|---|---|---|---|
|
Serves as subject matter expert on navigating TB, HIV, and STD Integrated System (THISIS). |
Provides expert consultation on:
|
Provides expert nursing consultation on:
|
Performs program evaluation and program reviews to ensure:
|
|
Manages all reported TB data |
Responds to TB data requests |
Responds to medication supplies/shortages |
Leads the cohort review process |
|
Submits data and reports to Centers for Disease Control and Prevention (CDC) |
Reports:
|
Provides education and training on:
|
Maintains and Evaluates: |
|
Sets TB reporting standards |
Identifies transmission patterns using genotyping and whole genome sequencing |
Sets TB standards of care |
Manages and Evaluates:
|
Targeted Testing Initiatives
Local health departments in selected urban and border counties receive funding from the Tuberculosis (TB) Program to establish a TB screening program organization that serves high-risk groups. Individuals identified with latent TB infection are referred to the appropriate health department for treatment and follow-up as appropriate.
Correctional TB
The Correctional TB Program provides technical assistance to all county jails and other correctional facilities covered by Chapter 89 of the Texas Health & Safety Code (the statutes) and Title 25, Part I, Chapter 97, Subchapter H (the rules) of the Texas Administrative Code. These correctional facilities must have an approved TB control plan. The Correctional TB Program also consults with correctional facilities when they have a case of TB within their facility. The process makes it easier to identify people at risk of exposure. It also allows for continuity of care after release or transfer. For more information about ensuring continuity of TB therapy for detainees of the U.S. Immigration and Customs Enforcement (ICE) see SOP 8.13.1, Appendix V.
Court-Ordered Management
The Communicable Disease Prevention and Control Act is a comprehensive statute (codified as Chapter 81, Texas Health and Safety Code) that provides for numerous control measures which are available for use in protecting public health. When an individual who has, or is suspected of having, a communicable disease does not comply with the control order issued by the local health authority and/or DSHS, Subchapter G of Chapter 81 provides for court-ordered management of the patient.
The process by which a local health authority seeks court-ordered management of a person who has violated a control order is a cooperative effort between that local health authority/local health department staff and the city, county, or district attorney whose office represents them in legal matters.
The Office of General Counsel of the Department of State Health Services is available to answer questions from local attorneys seeking court-ordered management in their jurisdictions.
Drug-Resistant TB (DRTB) Monitoring Program
The DRTB Program coordinates, tracks, and monitors all reported laboratory-confirmed drug-resistant TB cases throughout their course of treatment. The program works with medical providers to ensure rapid notification of the drug-resistant status. It assists the provider in obtaining expert TB consultation to ensure that the patient is provided with an adequate treatment plan and that the provider is aware of DSHS policies and requirements relevant to drug-resistant TB. Consultations by designated TB experts are recommended and strongly encouraged for all cases with resistance to isoniazid only, rifampin only, or both isoniazid and rifampin (MDR) combined with other TB drugs, pre-extensive drug-resistant TB (pre-XDR) and extensive drug-resistance TB (XDR). The program also monitors the directly observed therapy (DOT) policy, which is the standard of care in Texas in the treatment of TB patients.
Evaluation and Program Reviews
A regular system of reviews of TB programs has been established for local and regional health departments to assess the quality of service and to recommend strategies to improve the delivery of TB prevention and control services. Quantitative indicators of program performance are also monitored based on information contained in the TB case registry. Other indicators are derived from special performance or financial reports from local and regional TB programs.
Genotyping
Tuberculosis (TB) genotyping is a laboratory-based approach to analyzing the genetic material of Mycobacterium tuberculosis (M.tb). Common uses for genotyping results include identifying unknown transmission relationships, establishing outbreaks, detecting false positives and laboratory cross-contamination events, and distinguishing recent disease from activation of old disease. The TB genotyping program manages the genotyping database, tracks isolates submitted for genotyping, monitors genotyping results, performs cluster investigations, and provides epidemiologic consultations.? In addition, the program works very closely with laboratories and local health authorities to ensure all initial M.tb isolates are sent to the Department of State Health Services (DSHS) Laboratory in Austin per the Texas Administrative Code (Texas Administrative Code, Title 25, Part 1, Chapter 97, Subchapter A, Rule §97.3, (a), (4).
Hansen's Disease
The Hansen's Disease Program provides treatment for individuals with this disease in the state of Texas. The main goal of the program is to prevent deformity and disability from HD through early diagnosis and treatment. These services are federally funded through the:
- National Hansen’s Disease Program (NHDP)
- Department of Health and Human Services (DHHS)
- The Bureau of Primary Health Care
Technical Help
We offer help and consultation to local and regional health departments. We help by creating strategies to conduct public health follow-up after TB exposures. Such places are schools, workplaces, and residential institutions. Technical help with other TB prevention and care issues is also available upon request.