About Us


The Tuberculosis (TB) and Hansen's Disease Branch (TB Branch) administers TB program services statewide in accordance with Texas Health and Safety Code Chapter 31, Primary Health Care by allocating funds to local and regional health departments across the state to perform TB prevention and care activities.

The TB Branch establishes core elements to design a funded TB program, prepares and maintains standards of care, and develops methods to deliver appropriate services. The TB Branch provides laboratory support, medications, testing supplies, courier transport, nursing and medical consultation services to funded TB programs to enhance service delivery capacity.

The activities performed at the state, regional and local levels support our vision and mission:

Vision
a Texas free of TB

Mission
to eliminate TB as a public health threat

These activities are outlined in the Texas Health and Safety Code, Chapters 81 and 89 [Texas Legislature], which detail the importance of identifying and reporting tuberculosis to the public health system.


Services We Provide

DSHS provides contractual support and technical assistance to the following areas:

  • Thirty local health departments to maintain TB programs
  • Eight public health regions to maintain TB services
  • Four binational TB programs to support prevention and care along the Texas/Mexico border
  • Consultation is available from DSHS - Recognized Tuberculosis Medical Consultants


Core Program Functions

Surveillance Epidemiology
Clinical Care Services
Continuing Quality Improvement
Serves as subject matter expert on navigating TB, HIV, STD Integrated System (THISIS).

Provides expert consultation on:

  • TB outbreaks
  • TB cluster investigations
  • TB contact Investigations

Provides expert nursing consultation on:

Performs program evaluation and program reviews to ensure:

  • Adherence to treatment
  • Case management
  • Contact investigation
Manages all reported TB data
Responds to TB data requests
Responds to medication supplies/shortages 
Leads the cohort review process
Submits data and reports to the Center for Disease Control and Prevention (CDC) 

Reports:

  • Disease trends
  • Disease rates
  • Quality assurance activities

Provides education and training on:

  • Case management
  • Program services

Maintains and Evaluates:

Sets TB reporting standards 
Identifies transmission patterns using genotyping and whole genome sequencing
Sets TB standards of care

Manages and Evaluates:

  • Branch resources
  • Vendor performance


Targeted Testing Initiatives

Local health departments in selected urban and border counties receive funding from the Tuberculosis (TB) Program to establish a TB screening program organization that serve high-risk groups. Individuals identified with latent TB infection are referred to the appropriate health department for treatment and follow-up as appropriate.


Correctional TB

The Correctional TB Program provides technical assistance to all county jails and other correctional facilities covered by Chapter 89 of the Texas Health & Safety Code (the statutes) and Title 25, Part I, Chapter 97, Subchapter H (the rules) of the Texas Administrative Code. These correctional facilities must have an approved TB control plan. The Correctional TB Program also consults with correctional facilities when they have a case of TB within their facility to facilitate identification of persons with risk of exposure and to facilitate continuity of care upon release or transfer. For more information about ensuring continuity of TB therapy for detainees of the U.S. Immigration and Customs Enforcement (ICE) see SOP 8.13.1, Appendix V (PDF).


Court-Ordered Management

The Communicable Disease Prevention and Control Act is a comprehensive statute (codified as Chapter 81, Texas Health and Safety Code) which provides for numerous control measures which are available for use in protecting the public health. When an individual who has, or is suspected of having, a communicable disease does not comply with the control order issued by the local health authority and/or DSHS, Subchapter G of Chapter 81 provides for court-ordered management of the patient.

The process by which a local health authority seeks court-ordered management of a person who has violated a control order is a cooperative effort between that local health authority/local health department staff and the city, county or district attorney whose office represents them in legal matters.

The Office of General Counsel of the Department of State Health Services is available to answer questions from local attorneys seeking court-ordered management in their jurisdictions.


Drug-Resistant TB (DRTB) Monitoring Program

The DRTB Program coordinates, tracks, and monitors all reported laboratory confirmed drug-resistant TB cases throughout their course of treatment. The program works with medical providers to ensure rapid notification of the drug resistant status. It assists the provider in obtaining expert TB consultation to assure that the patient is provided with an adequate treatment plan and that the provider is aware of DSHS policies and requirements relevant to drug resistant TB. Consultations by designated TB experts are recommended and strongly encouraged for all cases with resistance to isoniazid only, rifampin only, or both isoniazid and rifampin (MDR) combined with other TB drugs, pre-extensive drug resistant TB (pre-XDR) and extensive drug-resistance TB (XDR). The program also monitors the directly observed therapy (DOT) policy, which is the standard of care in Texas in the treatment of TB patients.


Evaluation and Program Reviews

A regular system of reviews of TB programs has been established for local and regional health departments to assess the quality of service and to recommend strategies to improve the delivery of TB prevention and control services. Quantitative indicators of program performance are also monitored based on information contained in the TB case registry. Other indicators are derived from special performance or financial reports from local and regional TB programs.


Genotyping

Tuberculosis (TB) genotyping is a laboratory-based approach to analyze the genetic material of Mycobacterium tuberculosis (M.tb). Common uses for genotyping results include, identifying unknown transmission relationships, establishing outbreaks, detecting false positives and laboratory cross-contamination events and distinguishing recent disease from activation of old disease. The TB genotyping program manages the genotyping database, tracks isolates submitted for genotyping, monitors genotyping results, performs cluster investigations and provides epidemiologic consultations.  In addition, the program works very closely with laboratories and local health authorities to ensure all initial M.tb isolates are sent to the Department of State Health Services (DSHS) Laboratory in Austin per the Texas Administrative Code (Texas Administrative Code, Title 25, Part 1, Chapter 97, Subchapter A, Rule §97.3, (a), (4).


Hansen's Disease

The Hansen's Disease Program provides treatment for individuals with this disease in the state of Texas. These services are federally funded through the National Hansen’s Disease Program (NHDP), an activity in the Department of Health and Human Services (DHHS), and the Bureau of Primary Health Care. The primary goal of the program is to prevent deformity and disability from HD through early diagnosis and treatment.


Technical Assistance

Assistance and consultation are provided to local and regional health departments in devising strategies to conduct contact investigations in congregate settings such as schools, workplaces and residential institutions. Technical assistance with other TB prevention and care issues is also available upon request.



Last updated May 25, 2021