HJAR Sep/Oct 2022

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2022 41 Jennifer Dillaha, MD Director Arkansas Department of Health 2018 (4 deaths). These are heartbreaking tragedies, considering that TB is a curable disease if diagnosed in a timely manner and treated appropriately. The ADH is working to turn the tide of undiagnosed TB and missed care toward progress once more. TheADH is partnering with the Centers for Disease Control and Prevention (CDC) in their “Think. Test. Treat TB” campaign. THINK TB: • In anyone with persistent or recur- rent respiratory infection (especially pneumonia), prolonged cough (over two weeks), persistent fever, and un- explained weight loss. • In anyone with recent exposure to someone with active TB. • In people at higher risk for TB expo- sure: people from regions of the world with high TB rates (including Asia, Af- rica, Latin America, and the Pacific Is- lands) or who have worked or stayed in congregate settings like homeless shel- ters and prisons or worked in hospitals. • In people with weakened immune sys- tems due to certain medications and health conditions such as diabetes, cancer, and HIV. TEST FOR TB: • Blood tests including the QuantiF- ERON-TB Gold and the T-SPOT.TB are available through commercial laboratories. TB skin tests are also still widely available. • Chest X-ray should be done on any- one with a positive blood test or skin test for TB. • Clinicians can have patients with per- sistent cough produce sputum speci- mens that can be cultured for TB at many labs, including the ADH Glen F. Baker Public Health Laboratory, where we offer a fast turn-around time on PCR testing for Mycobacterium tuber- culosis, the germ that causes TB. Just send specimens to the closest ADH lo- cal health unit to be brought to us by courier. TREAT TB: Anyone with a positive blood test or skin test for TB should be referred to theADH for further evaluation and treatment. We treat both latent and active TB free of charge to patients. Remember, there may be many people in Arkansas who have TB that have been missed so far because of the effects of the pandemic on the healthcare system. TB can be fatal, but it is curable. Help spread the message to Think. Test. Treat TB. For more information, contact the ADH TB Program at 501-661-2152 or visit the program’s web- page at https://www.healthy.arkansas.gov/ programs-services/topics/tuberculosis. n cases per year for the past several years. This was in no small part due to the hard work and leadership of Joseph Bates, MD, and the late William Stead, MD, noted Arkan- sas physicians and TB luminaries who also contributed to the control of TB around the world through their work with theArkansas Department of Health (ADH). Unfortunately, the pandemic has changed the trajectory of TB progress here inArkan- sas as well as much of the nation and the world. Many fewer cases were diagnosed in the U.S. in 2020 than in recent pre-pan- demic years, and 2021 case numbers suggest that we have not yet found all the “missing” undiagnosed TB cases. There are multiple suspected reasons for this: • Since early 2020, many people have been hesitant to go out and seek need- ed healthcare. • Many health department staff were diverted from their regular duties to assist with the enormous demands of COVID-19 case investigation, contact tracing, and vaccinations. • Hospital staff were strained by the burden of huge inpatient and inten- sive care unit caseloads during the pandemic. As a result, over the past two and a half years, many TB cases have been diagnosed at very late stages, resulting in very ad- vanced disease and even TB deaths. In fact, TB deaths in adults in Arkansas doubled in 2021 (8 deaths) compared to