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Module 7: Confidentiality in Tuberculosis Control

In this module, you will learn what confidentiality means in the context of tuberculosis (TB) control. Confidentiality is an essential issue in many different aspects of TB control. Health care workers need to be aware of the confidentiality issues that are relevant to patient-health care worker encounters, as well as to the collection, management, and sharing of data gathered on TB patients. In the treatment of TB disease, the relationship between the patient and the health care worker is extremely important because of the serious consequences of treatment failure. If patient information is disclosed to unauthorized persons without the patient's permission, the patient may be stigmatized or experience rejection from family and friends, lose a job, or be evicted from housing. Moreover, the health care worker may lose the trust of the patient, which can affect adherence to TB treatment. Therefore, confidentiality — the responsibility to protect a patient's private information — is critical in TB control.

This module highlights specific situations in which a health care worker needs to consider and protect the rights of TB patients. It discusses general recommendations for developing trust with a patient, limiting disclosures, negotiating conflicts, and following due process. By using the recommendations in this module, you should be able to protect the confidentiality of your patients' personal information and help the program fulfill its responsibilities to the public.


After working through this module, you will be able to:

  1. Explain what confidentiality is, and why it is important to TB control.
  2. List four serious consequences that may result from revealing personal information without the patient's permission.
  3. Explain the patient-health care worker relationship and how it is like an agreement between two parties.
  4. Define health care worker and third party, and explain the difference between these two terms.
  5. Explain why trust is a key element in a successful patient-health care worker relationship and three ways to develop trust.
  6. List four types of patient's rights and describe their purposes.
  7. Describe how confidentiality is an essential issue in several of the core components of a TB control program.
  8. Describe how confidentiality is important in the identification and management of TB cases and in ensuring adequate therapy.
  9. Describe what should be done to protect a patient's rights during a contact investigation and screening for tuberculosis.
  10. Explain how other program activities, especially those involving data collection and analysis, require measures to provide data security and protect confidentiality.
  11. List the ways in which a patient's confidentiality can be protected in any situation: in an office, clinic, institution, or the field.

New Terms

Lists of new terms were introduced in each of the five core Self-Study Modules on Tuberculosis (Modules 1-5). Please refer to the core modules or their Glossary if you encounter unfamiliar terms related to TB that are not defined in this New Terms section.

Look for the following new terms in this module.

authorization - permission given by the patient to allow a third party to have access to the patient's confidential information

autonomy - the right of a patient to determine what will be done with his or her body, personal belongings, and personal information; this concept applies to any adult person who is mentally competent

confidentiality - the protection of information revealed during patient-health care worker encounters, including all written or electronic records of these encounters

consent - acceptance or approval of what is planned or done; it involves voluntary agreement to an action, whether it is a treatment option or a diagnostic test; the patient-health care worker relationship is founded on the patient's consent to the care being provided

court order - an order issued by a court mandating DOT or, in very rare cases, detention in a facility until treatment is completed

disclosure - the act of revealing or distributing personal information

due process - an established course for governmental activities or procedures, designed to safeguard the legal rights of the individual

health care worker - any member of a team of health professionals who care for and manage a TB patient, including physicians, nurses, outreach workers, hospital discharge planners, pharmacists, and social workers

informed consent - a patient's written consent to a surgical or medical procedure or other course of treatment, given after the health care worker has informed the patient about the potential benefits, risks, and alternatives involved

partner notification - an activity conducted by HIV/AIDS programs to identify and counsel the sexual and needle-sharing contacts of HIV-infected persons; this notification is confidential and depends on the voluntary cooperation of the patient

patient-health care worker relationship - the basis for sharing information, communicating beliefs and feelings that affect care, and building trust in the value of the interaction

patient-identifiable information - information in which the identity of the patient is directly included or can be deduced

privileged information - personal information shared by the patient with his or her health care worker

routine case reporting - the required reporting of suspected or confirmed TB cases to a public health authority

statement of disagreement - a statement filed by the patient stating there is a disagreement with the health care worker or institution regarding the patient's record

third party - a person or an organization not directly involved in the care of a patient's health problem

waiver - a form that patients are often asked to sign to allow their health information to be used by third parties

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    Division of Tuberculosis Elimination (DTBE)
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