Self-Study

Self-Study Modules
Modules On
OnTuberculosis
Tuberculosis

MODULES
MODULES

1–5 Introduction
 MODULES

Self-Study Modules
on Tuberculosis

Introduction

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination

Atlanta, Georgia
2019
Self-Study Modules on Tuberculosis
The Self-Study Modules on Tuberculosis is a series of educational modules designed to provide
information about tuberculosis (TB) in a self-study format. The series consists of nine modules
that are separated into two parts. The frst part, Modules 1–5, provides basic information on
TB. The second part, Modules 6–9, provides more specifc TB programmatic information. It is
recommended that you work through Modules 1–5 before proceeding to Modules 6–9.

Target Audience
The target audiences for this course are outreach workers, nurses, physicians, administrators,
health educators, and students from a variety of settings, including
z TB programs
z Other public health agencies, such as HIV/AIDS, STD, and viral hepatitis programs
z Managed care organizations
z Correctional facilities
z Community-based organizations
z Homeless shelters
z Migrant clinics
z Substance abuse facilities
z Nursing and medical schools
z Other facilities serving persons with or at risk for TB

Modules 1–5 — Introduction

1
 About Modules 1–5
The Self-Study Modules on Tuberculosis, 1-5 package includes fve modules, an introduction, and
a glossary.
z Introduction (this booklet)

z Module 1: Transmission and Pathogenesis of Tuberculosis

z Module 2: Epidemiology of Tuberculosis
z Module 3: Targeted Testing and the Diagnosis of Latent Tuberculosis Infection and
Tuberculosis Disease
z Module 4: Treatment of Latent Tuberculosis Infection and Tuberculosis Disease
z Module 5: Infectiousness and Infection Control
z Glossary
A few topics have been repeated in several of the modules to enable the modules to be used either as a
complete course or as stand-alone booklets.

Each module contains the following sections:

z Background: Background information to help you understand the purpose of the module.

z Objectives: A guide to the information you should learn from the module.
z New Terms: A list of terms that are introduced in the module and listed in the glossary.
z Reading Material: The reading material for the module, including diagrams, charts, illustrations,
and photographs.
z Study Questions: Sets of questions, spread throughout the reading material, designed to help
you assess how well you have learned the content of the module. Be sure to take advantage of
these valuable exercises because they will help you prepare for the fnal examination. Answers
are provided at the end of the module so that you can check your work.
z Case Studies: Case studies designed to help you apply the concepts you have learned in the
module. Answers are provided at the end of the module so that you can check your work.
z Additional Resources: A list of references for additional information.

2 Modules 1–5 — Introduction

Objectives
After completing Modules 1-5, participants will be able to do the following:
Module 1: Transmission and Pathogenesis of Tuberculosis
1. Describe the history of TB.

2. Explain how TB is spread (transmission).

3. Defne drug-resistant TB.

4. Explain the diference between latent TB infection (LTBI) and TB disease.

5. Explain how LTBI and TB disease develop (pathogenesis).

6. Describe the classifcation system for TB.

Module 2: Epidemiology of Tuberculosis

1. Describe how the number of TB cases reported in the United States has changed over the
last 65 years.

2. List fve factors that contributed to the increase in the number of TB cases between 1985
and 1992.

3. List three improvements TB programs were able to make with increased federal, state,
and other funds and resources that have contributed to a decrease in TB cases since 1993.

4. List the groups of people who are more likely to be exposed to or infected with
M. tuberculosis.

5. List the groups of people who are more likely to develop TB disease once infected with
M. tuberculosis.

Modules 1–5 — Introduction

3
 Module 3: Targeted Testing and the Diagnosis of Latent Tuberculosis
Infection and Tuberculosis Disease
1. Identify high-risk groups for targeted testing.

2. Describe how to interpret an interferon-gamma release assay.

3. Describe how to place, read, and interpret a Mantoux tuberculin skin test.

4. Discuss considerations for using either an interferon-gamma release assay or the Mantoux
tuberculin skin test for diagnosing LTBI.

5. Describe the components of a medical evaluation for diagnosing TB disease.

Module 4: Treatment of Latent Tuberculosis Infection and Tuberculosis Disease

1. List the groups of people who should receive high priority for LTBI treatment.

2. Describe treatment regimens for LTBI.

3. Describe treatment regimens for TB disease.

4. Describe the principles of preventing drug resistance.

5. Describe patient monitoring during LTBI and TB disease treatment.

6. Describe TB treatment adherence strategies.

7. List the common adverse reactions to the drugs used to treat LTBI and TB disease.

Module 5: Infectiousness and Infection Control

1. Describe the factors that determine the infectiousness of a TB patient.

2. Describe the main goals of a TB infection-control program.

3. Describe the three levels of control measures that are the basis of an efective infection-
control program.

4. Describe the purpose and the characteristics of a TB airborne infection isolation room.

5. Describe the circumstances when personal respirators should be used.

4 Modules 1–5 — Introduction

Companion Products
Modules 6–9
Self-Study Modules on Tuberculosis, 6–9, includes four modules, an introduction, and a glossary.
z Introduction
z Module 6: Managing Tuberculosis Patients and Improving Adherence
z Module 7: Patient Rights and Confdentiality in Tuberculosis Control
z Module 8: Contact Investigations for Tuberculosis
z Module 9: Tuberculosis Outbreak Detection and Response
z Glossary

To View or Order the Modules

To view or download the Self-Study Modules on Tuberculosis, 1–5 and the Self-Study Modules on Tuberculosis,
6–9, visit www.cdc.gov/tb/education/ssmodules/.
If you would like to request a print copy of the Self-Study Modules on Tuberculosis, 1–5 or 6–9,
please use the CDC Division of Tuberculosis Elimination’s online ordering system:
https://wwwn.cdc.gov/pubs/CDCInfoOnDemand.aspx.

Modules 1–5 — Introduction

5
 Continuing Education
Continuing education (CE) is ofered free of charge for various professions based on approximately
5 hours of instruction for Modules 1–5. In order to receive CE credit/contact hours, you must complete
an exam and course evaluation. A minimum score of 70% is necessary to receive credit/contact hours.
Upon successful completion of the course, exam, and evaluation, your CE certifcate will be issued by
CDC Training and Continuing Education Online.
For the most up-to-date information regarding CE for Modules 1–5, please refer to the CDC Division of
Tuberculosis Elimination’s website (www.cdc.gov/tb/education/ssmodules/cont_ed_regist.htm).
z Prerequisites: None
z Format: Enduring material
z Origination Date: June 01, 2020
z Expiration Date: June 01, 2022

Accreditation Statements
In support of improving patient care, The Centers for Disease Control and Prevention is jointly accredited
by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for
Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing
education for the healthcare team.
CME: The Centers for Disease Control and Prevention designates this enduring activity for
a maximum of 6 AMA PRA Category 1 Credits™. Physicians should claim only the credit
commensurate with the extent of their participation in the activity.
CNE: The Centers for Disease Control and Prevention designates this activity for 6 nursing
contact hours.
CEU: The Centers for Disease Control and Prevention is authorized by IACET to ofer 0.6 CEU’s for
this program.
CECH: Sponsored by the Centers for Disease Control and Prevention, a designated provider of
continuing education contact hours (CECH) in health education by the National Commission for
Health Education Credentialing, Inc. This program is designated for Certifed Health Education
Specialists (CHES®) and/or Master Certifed Health Education Specialists (MCHES®) to receive up
to 6.0 total Category I continuing education contact hours. Maximum advanced level continuing
education contact hours available are 6.0. Continuing Competency credits available are 6.0 CDC
provider number 98614.
For Certifed Public Health Professionals (CPH): The Centers for Disease Control and Prevention is
a pre-approved provider of Certifed in Public Health (CPH) recertifcation credits and is authorized
to ofer 6.0 CPH recertifcation credits for this program.

6 Modules 1–5 — Introduction

 DISCLOSURE: In compliance with continuing education requirements, all presenters must
disclose any fnancial or other associations with the manufacturers of commercial products,
suppliers of commercial services, or commercial supporters as well as any use of unlabeled
product(s) or product(s) under investigational use.
CDC, our planners, content experts, and their spouses/partners wish to disclose they have
no fnancial interests or other relationships with the manufacturers of commercial products,
suppliers of commercial services, or commercial supporters. Planners have reviewed content to
ensure there is no bias.
Planning committee reviewed content to ensure there is no bias..
Content will not include any discussion of the unlabeled use of a product or a product under
investigational use.
CDC did not accept commercial support for this continuing education activity.

To receive Continuing Education (CE)

To receive continuing education for the Self-Study Modules on Tuberculosis, 1–5, you must
z Complete the activity

z Complete the evaluation at https://tceols.cdc.gov

z Pass the posttest at 70% at https://tceols.cdc.gov

Fees: No fees are charged for CDC’s CE activities.

Other TB Education and Training Materials

z CDC TB Education and Training Materials – www.cdc.gov/tb
Please visit the CDC Division of Tuberculosis Elimination’s website for information on other available
CDC-produced TB education and training materials.
z The Find TB Resources Website – http://findtbresources.cdc.gov
This site includes a searchable database of materials from numerous national and international
organizations. This website is intended for use by TB and other health care professionals, patients,
and the general public.

Modules 1–5 — Introduction

7
 z TB Centers of Excellence for Training, Education, and Medical Consultation (TB COEs)
The CDC Division of Tuberculosis Elimination funds four TB Centers of Excellence for Training,
Education, and Medical Consultation (TB COEs). The TB COEs are regionally assigned to cover all
50 states and the U.S. territories. The TB COEs support domestic TB control and prevention eforts
with a focus on two major activities:
y Increasing human resource development through education and training activities; and
y Increasing the capacity for appropriate medical evaluation and management of persons
with TB disease and LTBI through medical consultation.
Curry International Tuberculosis Center
2001 Center Street, Suite 700
Berkeley, CA 94704
Phone: 510-238-5100
Email: [email protected]
Website: www.currytbcenter.ucsf.edu

Global Tuberculosis Institute at Rutgers, The State University of New Jersey

225 Warren Street
Second Floor East Wing
Newark, NJ 07103
Phone: 973-972-3270
Fax: 973-972-3268
Email: [email protected]
Website: http://globaltb.njms.rutgers.edu

Heartland National Tuberculosis Center

2303 SE Military Drive
San Antonio, TX 78223
Phone: 800-TEX-LUNG (800-839-5864)
Fax: 210-531-4590
Website: www.heartlandntbc.org

Southeastern National Tuberculosis Center

2055 Mowry Road
Gainesville, FL 32611
Mailing Address:
PO Box 103600
Gainesville, FL 32610
Phone: 352-273-7682
Fax: 352-273-9275
Email: [email protected]
Website: http://sntc.medicine.ufl.edu/

8 Modules 1–5 — Introduction

 z COEs TB Training and Education Products Webpage—
https://sntc.medicine.ufl.edu/rtmccproducts.aspx
This webpage includes all educational materials developed by the CDC-funded TB COEs.
Resources include print, video, and webinars.

Additional Questions
For additional information on TB, visit the CDC Division of Tuberculosis Elimination’s website at
www.cdc.gov/tb. If you have additional questions, you may also contact CDC-INFO at
http://wwwn.cdc.gov/dcs/RequestForm.aspx.

If you have questions on state-specifc TB guidelines, please contact your state TB control ofce. A list
of state TB control ofces can be found on the CDC Division of Tuberculosis Elimination’s website at
http://www.cdc.gov/tb/links/tboffices.htm.

Acknowledgements
The CDC Division of Tuberculosis of Elimination would like to acknowledge the following subject matter
experts for their valuable assistance in the development of The Self-Study Modules, 1-5:

CDC Division of Tuberculosis Elimination CDC Division of Global Migration and Quarantine
Nickolas DeLuca, PhD Drew Posey, MD, MPH
John Jereb, MD
CDC Division of Creative Services
Amera Khan, MPH Curt Wommack, BFA
Philip LoBue, MD, FACP, FCCP In addition, CDC DTBE would like to thank all those
Elvin Magee, MPH, MS who participated in feld testing these modules.
Allison Maiuri, MPH, CHES
Sundari Mase, MD, MPH
Thomas R. Navin, MD
Robert Pratt, BS
Sarah Segerlind, MPH
Carissa Sera-Josef, MS, CHES
Maria Fraire Sessions, MPH, CHES
Angela Starks, PhD
Clarisse Tsang, MPH
Andrew Vernon, MD
Wanda Walton, PhD, MEd
Carla Winston, PhD

Modules 1–5 — Introduction

9
 Notes

10 Modules 1–5 — Introduction

 Publication Number 00-6514

CS321713-A