The Tuberculosis programs of the Roanoke and Alleghany Health Districts provide services to persons with active tuberculosis (TB), latent tuberculosis infection ( LTBI ) and those who are suspected of having the disease prior to their final diagnosis. Medicines, education, and in extreme situations, food and housing may be provided to persons in need who meet certain requirements.
Although the incidence of tuberculosis disease has been decreasing for many years there have been years such as 1998 when the districts had 12 tuberculosis cases and six suspects reported. Suspects are treated as cases until tuberculosis is ruled out. The local health departments work closely with private physicians to render care to patients. Our objectives include directly observed therapy (DOT) on all TB cases, helping patients who must be isolated cope with food and shelter, providing medicine to those who cannot afford it, providing transportation, x-rays and other testing as needed. Persons in contact with TB cases, an airborne disease, are tested for TB and treated as appropriate.
Because of new state laws regarding TB, hospitals must work with local health departments to develop discharge plans for patients prior to their release. This is to insure that infected patients have a care plan that addresses both their medical and personal care and the safety of the community into which they are released. Several times housing, food, transportation and medicine were required to meet the needs of patients and the community. Through the Southwest Virginia Funds provided by the TB Foundation, a locally administered private grantor, the needs of our patients are met. This fund has provided thousands of dollars of assistance to patients in Southwest Virginia over the years.
Over the last 10 years the Roanoke City Health Department has had over 500 LTBI patients complete six months of preventative therapy to reduce their chance of developing TB disease. Persons with LTBI , have TB germs as indicated by their positive skin tests, but have normal chest X-rays and lack of TB symptoms. These people can not infect others in this form, but have some chance of developing disease as their germs are merely encapsulated by the body and may emerge years later. Preventative therapy reduces their chance of ever developing TB disease. Most of these patients have weekly medicine delivery and frequent contact with health department personnel to help insure their completing of therapy.
Local health departments have utilized an outreach worker ( ORW ) for medicine delivery, education and transportation. The Virginia Lung Association provides for the ORW through funds from the Southwest Virginia Fund. Since 1995, the Roanoke City Health Department ( RCHD ) has provided care to persons from 11 countries other than the United States . Interpreters from the health department and other organizations have met the challenge of providing care to these patients.
The Virginia Division of TB Control, Virginia Department of Health, has given an annual award, the Traveling Spittoon Award, to the health department in each of the five state regions for the last four years. The award is given to the locality on the basis of patient completion of treatment, by percent of patients on Directly Observed Therapy, the percentage of contacts to patients who complete preventative therapy and other complicating factors. The Roanoke City Health Department has won the “Spittoon” in three of the four years of this award. In the year 2003, the RCHD met each element of the criterion at 100 percent.
The local health departments of these districts continue to overcome any of the many challenges of this disease
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