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Purpose: Rates of tuberculosis (TB) in the past ten years has been steadily declining in the United States, but a similar trend has not been seen in the state of Nevada. There have been approximately 100 cases of active TB disease diagnosed in Nevada annually for the past five years. Appropriate management of TB disease following initial diagnosis can prevent further transmission and development of multi drug resistant organism. The Center for Disease Control and Prevention (CDC) recommends that all persons with active TB disease be treated under Direct Observational Therapy (DOT), which may not be possible if treatment is initiated by a private provider.
Methods: The Nevada Administrative Code 441A was updated to reflect the following change: Pharmacies/pharmacists dispensing two or more TB drugs (isoniazid, rifampin, ethambutol, or pyrazinamide) are required to report to the Nevada State Health Authority according to the update, effective January 1st, 2011. Pharmacy/pharmacist reporting active TB disease is another possible way to identify cases. The law requires all pharmacies to include their name, address, contact information, name of the reporting pharmacist, patient demographics, medications prescribed and prescriber information. Increasing rates of reporting can help to identify and manage TB disease appropriately.
Results: Since the implantation of the law, a total of 6 cases in Nevada have been reported by pharmacies/pharmacist, which is greater than 5% of the total number of active cases reported annually.
Conclusion: Appropriate drug therapy is imperative for effective TB control. Reporting active TB cases to the Health Authority by pharmacy/pharmacist can facilitate additional follow up that may not be available at through a provider’s office. This is an additional tool to identify unreported active TB disease. Early identification allows for appropriate contact investigation and decreases the spread of this highly contagious respiratory disease.