National Tuberculosis Coalition of America (NTCA) Guidelines for Respiratory Isolation and Restrictions to Reduce Transmission of Pulmonary Tuberculosis in Community Settings

Shah, Maunank; Dansky, Zoe; Nathavitharana, Ruvandhi; Behm, Heidi; Brown, Shaka; Dov, Lana; Fortune, Diana; Gadon, Nicole Linda; Gardner Toren, Katelynne; Graves, Susannah; Haley, Connie A; Kates, Olivia; Sabuwala, Nadya; Wegener, Donna; Yoo, Kathryn; Burzynski, Joseph

doi:10.1093/cid/ciae199

Clinical Infectious Diseases

2024

DOI: 10.1093/cid/ciae199

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National Tuberculosis Coalition of America (NTCA) Guidelines for Respiratory Isolation and Restrictions to Reduce Transmission of Pulmonary Tuberculosis in Community Settings

Maunank Shah,

Zoe Dansky,

Ruvandhi Nathavitharana

et al.

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Cited by 3 publications

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Overview of the Epidemiology, Diagnosis, and Clinical Care Considerations for People Living with and at Risk for Tuberculosis in the United States

Bergman,

Thomas

2024

Nursing Clinics of North America

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Overview of the Epidemiology, Diagnosis, and Clinical Care Considerations for People Living with and at Risk for Tuberculosis in the United States

Bergman,

Thomas

2024

Nursing Clinics of North America

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Effects of Respiratory Isolation for Tuberculosis to Reduce Community-based Transmission: A Systematic Review

Nathavitharana,

Pearl,

Biewer

et al. 2024

Clinical Infectious Diseases

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Background Respiratory isolation of people with pulmonary tuberculosis (TB), including after treatment initiation, is used to prevent community-based transmission; yet guidelines on duration are limited and implementation is heterogeneous. This systematic review synthesized evidence on respiratory isolation for TB to inform National TB Coalition of America guidelines. Methods After searching six databases, eight reviewers screened and extracted data in duplicate on effects of respiratory isolation compared to no isolation or masking. Studies were stratified by outcomes: TB infection or disease in contacts, mortality, hospitalization duration, patient and health system costs, and impact on mental health or stigma. We used a convergent integrated approach to synthesize quantitative and qualitative findings and assess limitations. Results Seventeen studies were included. There were limited data directly comparing isolation to non-isolation interventions, including effects after treatment initiation. One randomized controlled trial suggested treatment in a sanatorium versus at home did not affect TB incidence in contacts. Modelling studies suggest isolation may reduce transmission, but relied on various assumptions, and isolation was implemented alongside other interventions. Descriptive, mixed-methods, and qualitative studies described adverse impacts of isolation on employment, education, food/housing security, and mental health due to transmission fears, stigma and social isolation. Impacts were compounded in marginalized groups including indigenous and incarcerated persons. Conclusion Data to support current isolation practices, particularly after effective treatment initiation, to reduce TB transmission in communities are limited. Public health guidance should weigh the negative impacts on people with TB against decreased community transmission to make evidence-based decisions about respiratory isolation.

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Stigma relating to tuberculosis infection prevention and control implementation in rural health facilities in South Africa — a qualitative study outlining opportunities for mitigation

van der Westhuizen,

Ehrlich,

Somdyala

et al. 2024

BMC Global Public Health

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National Tuberculosis Coalition of America (NTCA) Guidelines for Respiratory Isolation and Restrictions to Reduce Transmission of Pulmonary Tuberculosis in Community Settings

Cited by 3 publications

References 82 publications

Overview of the Epidemiology, Diagnosis, and Clinical Care Considerations for People Living with and at Risk for Tuberculosis in the United States

Overview of the Epidemiology, Diagnosis, and Clinical Care Considerations for People Living with and at Risk for Tuberculosis in the United States

Effects of Respiratory Isolation for Tuberculosis to Reduce Community-based Transmission: A Systematic Review

Stigma relating to tuberculosis infection prevention and control implementation in rural health facilities in South Africa — a qualitative study outlining opportunities for mitigation

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