Guide to the Application of Genotyping to Tuberculosis Prevention and Control
Developing a Tuberculosis Genotyping Program
Developing a Written Plan
TB Programs should develop a written plan to describe activities, responsibilities, and procedures for their TB genotyping programs. The New York City and the Maryland TB programs graciously agreed to share copies of their genotyping plans with other TB controllers. These plans are posted on the WebBoard at http://web-tb.forum.cdc.gov.
To help TB programs develop a plan, Table 5.1 lists important initial steps that should be considered. Which steps are required and which are recommended depend on the decision the TB program makes about the initial scope of their genotyping program. How to make the decision about the initial scope of the genotyping program and the steps in Table 5.1 are discussed in the next section of this chapter.
Table 5.1. Steps in establishing a state genotyping program plan.
|Universal: statewide||Universal: subregion||Selective|
|1. Identify labs that might submit isolates||Required||Required||Recommended|
|2. Notify submitting labs of genotyping program and provide them with a copy of the TB Genotyping Isolate Submission form||Required||Required||Recommended|
|3. Negotiate payment for shipping isolates to genotyping laboratories||Required||Required||Recommended|
|4. Establish submission procedures: batch shipments, frequency of shipments, avoiding duplicate submissions||Required||Required||Required|
|5. Establish an isolate tracking system||Required||Required||Required|
|6. Establish criteria for selecting isolates to be submitted||does not apply||does not apply||Recommended|
|7. Establish procedures to identify isolates selected for submission||does not apply||does not apply||Required|
|8. Assign responsibility to the person who will receive Genotyping Laboratory Report||Required||Required||Required|
|9. Establish a genotyping data management system||Required||Required||Required|
|10. Establish procedures for evaluating genotyping results and other existing data to make decisions about need for additional investigations, such as cluster or outbreak investigations (see Figure 5.1)||Required||Required||Required|
|11. Establish criteria for requesting RFLP||Required||Required||Required|
|12. Consider advocating for a new state health regulation to submit one isolate/patient to state public health laboratory||Recommended||Recommended||Recommended|
|13. Consider networking with adjacent TB programs to encourage interjurisdictional exchange of genotyping information||Recommended||Recommended||Recommended|
|14. Obtain CDC approval for plan||Required||Required||Required|