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APHA Scientific Session and Event Listing

Sandra D. Daniel, PhD, RN, CPNP, Accelerated BSN Program, Georgia Southwestern State University, 800 Wheatley St, Americus, GA 31709, 229-931-2280, sdd@canes.gsw.edu

Background: While the rate of TB is declining in the U.S., some of the highest rates in the country are in the southeast, where Georgia ranks seventh nationally. Georgia's TB cases rates for racial/ethnic groups have been decreasing since 1993 except in Hispanics. More that half of state's new TB cases reported came from foreign-born were diagnosed with TB within five years after arrival in the US. Targeted tuberculosis (TB) surveillance is a recommended strategy for the elimination of TB in the U.S. Latino farmworkers is a rapidly growing population in rural Georgia, with many working and settling in health professional shortage areas. This population has limited resources, including bilingual professionals. No data is available concerning the rate of latent tuberculosis infection (LTBI) among this population. Project: TB surveillance was implemented targeting Latino farmworkers. Nurses and health outreach workers worked collaboratively to plan, implement, and evaluate this project. A team-approach was utilized to plan and organize the infrastructure of the project. Certified community health outreach workers (HOWs) visited small groups of the target population prior to screening, using culturally appropriate multi-method health education strategies. This was followed by subsequent visits that included the professional nursing staff and HOWs to initiate testing and interpret results. HOWs facilitated access to rural health clinic services to improve service utilization and provided case management. Results: The Community Outreach Model was used to systematically evaluate the initiative. 136 (88%) of 154 tested were read, with 32 (21%) positive (Ан 10 mm). Twenty-four (75%) of the 32 positive results were medically evaluated. Nine initiated treatment, with five completing therapy, two discontinuing for medical reasons, and two for personal reasons. Of the 15 not initiating treatment, fourteen returned to Mexico, thus preventing timely surveillance. HOWs delivery of culturally competent strategies were found to be a critical component to project success.

Learning Objectives:

• Discuss national, state, and regional prevalence of LTBI and implications for Hispanic farmworkers.
• Describe development and implementation of TB surveillance program that targets high-risk migrant and seasonal farmworkers in southwest Georgia.
• Discuss the role of the community health nurse in providing TB surveillance
• Discuss role of health outreach workers in the identification, pre-screening education, and casemanagement as key components of a successful surveillance program.

Keywords: Tuberculosis, Access and Services

Presenting author's disclosure statement:

Not Answered