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Volume 17, Number 3—March 2011

CME ACTIVITY

Tuberculosis among Health Care Workers

Earning Medscape CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions and earn continuing medical education (CME) credit, please go to www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.com. If you are not registered on Medscape.com, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association's Physician's Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

Tuberculosis among Health Care Workers

Medscape CME Questions

1. Based on the above meta-analysis by Dr. Baussano and colleagues, which of the following statements about the risk for healthcare workers (HCWs) of developing incident latent tuberculosis infection (LTBI) is most likely correct?

A. There is no clear evidence that TB is an occupational disease

B. Annual risk for LTBI among HCWs is not associated with background TB incidence in the population

C. Stratified pooled estimates for the LTBI rate for the countries with an estimated low

(<50 cases/100,000) TB incidence was 1.8%

D. Stratified pooled estimates for the LTBI rate for the countries with an estimated high

(>100 cases/100,000) TB incidence was 8.4%

2. You are asked by the World Health Organization to consult on expected risk of developing TB disease for HCWs worldwide. Based on the above meta-analysis, which of the following statements would be most likely to appear in the report of your findings?

A. The background TB incidence in the population is not associated with incidence rate ratios (IRRs) for TB disease

B. Median estimated population attributable fraction (PAF) percentage for TB disease exceeds 2%

C. For TB disease, IRR estimate is 2.4 for countries with estimated low or intermediate TB incidence, and 3.7 for countries with estimated high TB incidence

D. The impact of TB in HCWs on global TB burden exceeds 10%

3. As the consultant described in Question 2, which of the following statements about suggested TB infection control measures is most likely to appear in your report, based on the above meta-analysis?

A. Infection transmission control strategies are not likely to be effective

B. Implementing TB infection control measures is recommended only at select healthcare facilities caring for patients suspected of having infectious TB

C. Administrative controls alone are ineffective in reducing the risk for TB among HCWs

D. Managerial activities, administrative controls, N95 respirators, and engineering controls are all potentially effective in reducing the risk for TB among HCWs

Activity Evaluation

1. The activity supported the learning objectives.
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2. The material was organized clearly for learning to occur.
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3. The content learned from this activity will impact my practice.
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4. The activity was presented objectively and free of commercial bias.
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