Effective TB Interviewing for Contact Investigation: Self-Study Modules
The TB interview
Once it has been determined who will be interviewed, priority must be assigned to the interviews. All interviews should be initiated within 72 hours of TB suspect/case report. Follow-up interviews may occur to obtain additional information. A second complete interview or re-interview should be done within 2 weeks of initial interview to determine additional information that the patient may not have shared for various reasons and to confirm previously obtained information. The infectiousness of a patient and his or her ability to transmit disease is the main consideration for prioritizing the interview. Infectiousness is determined by
- Site of disease (pulmonary, pleural effusion, miliary TB with cough, or laryngeal TB);
- Presence of cavitary disease;
- Positive acid-fast bacilli (AFB) sputum smear;
- Positive TB culture;
- Presence of cough or hoarseness;
- No treatment, recently started treatment, or inadequate treatment; and
- Length of time of symptoms.
Source case interviews take lower priority than interviews with infectious cases. However, this may change if the number of skin test conversions or occurrence of new TB cases is high in a particular setting. This will be covered in Module 4. Other considerations, which may also influence priority of interviews, are location of the patient, ability to locate the patient in the field, the patient’s history of nonadherence, and number of interviewers available.