Increasing Follow-up in College Students with Latent Tuberculosis Infection

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. Students presenting with LTBI to the SHC received a standardized message through the secure patient-portal regarding their diagnosis, treatment options and education about LTBI. It asked them to follow-up with a message, telephone call or in-person appointment. Prior to the intervention, most students with LTBI received no follow-up, and after the intervention 100% of new cases received follow-up. A total of 42 students were sent a secure message, 31 read the secure message and 13 of those students contacted the health center or an outside provider for further follow-up. Out of those 13 students, 7 started treatment for LTBI. The goals of this study were to increase follow-up and education around LTBI, and increase the number of students choosing treatment, all of these outcomes were met. The secure message system was a reliable way to contact students regarding their diagnosis and education around LTBI. Keywords: Latent tuberculosis, interferon-gamma release assay, tuberculin skin test, mycobacterium tuberculosi