Priority Populations for Treatment
CONTACT US
Public Health Clinic
3160 Center Street NE
Salem, OR 97301
Phone:
(503) 588-5611
Appointments offered Monday – Friday
8:30 a.m. to 4:30 p.m.
Tuberculosis Program Priorities
| Population Group In Order of Priority |
Service Provided |
Notes for Clarification |
| Clients with active tuberculosis | - Medical evaluation
- CXR
- Medication management
- Directly observed therapy
- Medical consultation by Dr. Karen Landers
- Contact investigation
| Private physicians may refer clients with known or suspected active Tuberculosis to MCHD for complete evaluation and care of their active Tuberculosis. See also: Clients who test positive at another provider |
Recent contacts of a known case of
active pulmonary or laryngeal TB
(Recent is defined as within the past two years) | - Tuberculosis testing
- Medical evaluation
- CXR
- Medication management
- Medical consultation by Dr. Karen Landers
| Private physicians may refer clients who have recently been exposed to active pulmonary or laryngeal TB for complete evaluation. Treatment of latent TB infection will be provided as medically indicated. See also: Clients who test positive at another provider Note: Clients with HMOs will be evaluated upon appropriate referral from their primary care physician so that the insurance may be billed for services provided by MCHD. If, after medical evaluation, treatment is recommended, the client will be referred back to the primary care physician for that care. |
Tuberculin converters who do not have a PCP and/or have limited financial resources.
Converter = Positive tuberculin skin test (TST) or interferon gamma release assay (IGRA) QFT or T Spot test now and documented negative test within the past two years
- or –
Increase in reaction size of
10mm or more within the previous two years for high risk populations
Increase in reaction size of
15mm or more within the previous two years for persons with no risk factors for TB | | Private physicians° may either - Seek medical consultation *, or
- Refer clients who test positive for complete evaluation. Treatment of latent TB infection will be provided as medically indicated.
See also: Clients who test positive at another provider Note: Clients with insurance will be encouraged to establish care with a primary care physician from whom they can receive evaluation and treatment. |
High risk clients who do not have a PCP and/or have limited financial resources.
High risk is defined as: - Diagnosed HIV or AIDS
- Fibrotic changes on chest x-ray with prior TB
- Immunosuppressed clients (receiving equivalent of 15 mg/d or greater of prednisone for 1 month or longer, or taking TNF alpha antagonists
- Recent (within 5 years) immigrants from countries with high prevalence of TB
- Injection drug users
- Silicosis
- Underweight (10% below ideal)
- Diabetes mellitus
- Chronic renal failure/ hemodialysis
- Gastrectomy
- Jejunoileal bypass
- Solid organ transplantation
- CA head or neck
- Recent employees or residents of institutional settings and/or correctional facilities
- Chronic Malabsorption Syndrome
- Leukemia
- Hodgkin's Disease
| - Tuberculosis skin testing
- Medical evaluation
- CXR
- INH medication management
- Medical consultation to private providers*
| Private physicians° may either - Seek medical consultation *, or
- Refer clients who test positive (more info) for complete evaluation. Treatment of latent TB infection will be provided as medically indicated
See also: Clients who test positive at another provider Note: Clients with insurance will be encouraged to establish care with a primary care physician from whom they can receive evaluation and treatment. |
| Residence 6 or more months in country with high prevalence of TB and left that country within the last 3 months. | - Tuberculosis skin testing
- Medical evaluation
- CXR
- INH medication management
| Eg missionaries, immigrants Client must have no other resources, eg PCP. |
Clients Who Tested Positive at Another Provider
If the client meets our priorities, but has limited financial resources, they can receive evaluation
and treatment from our TB program after at TB test is placed and ready by TB staff to verify the
TB test results.
If the test was given less than eight days prior to the client’s visit, and is ready as positive by the
TB staff, the staff may consult with the Health Officer about whether to repeat the test or
schedule for chest clinic. Alternatively, an IGRA (TB blood test) may be performed.
Note: TB test will not be repeated if the client had vesicles with the prior test
Clients That Do Not Meet Our Priorities for Tuberculin Skin Testing
Unless the client falls into one of our priority groups listed in the table above, the following
clients do not meet our priorities for tuberculin skin testing:
- Day care entry
- College entrance
- Adoption
- MD referrals
- Work clearance
- Self-referrals
- Immigrants in country less than five years
Private physicians do not include delegate agencies or providers of Marion County Health & Human Services. Delegate agencies evaluate and treat clients they identify with latent TB infection.
Medical consultation is provided by Caroline Castillo, MD, Health Officer, Marion County Health & Human Services.
Email Privacy: While we are happy to answer general questions via email, we suggest you do not transmit personal or health related information in your message. We cannot meet any expectation you might have of confidentiality when you communicate with us over the Internet. If you have a specific personal or health-related issue, please call the appropriate county government office instead.
Email address: health@co.marion.or.us
To report a public health emergency, or make an urgent report of communicable disease, call (503) 588-5621 at anytime.
