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In 2007, Toronto Public Health (TPH) developed a Contact Screening Parameters Tool (CSPT) to provide a more systematic, risk-based approach for prioritizing contact follow-up for pulmonary tuberculosis (TB) cases. The CSPT was based on an analysis of case and contact outcomes in Toronto as well as exposure-time parameters drawn from the literature, and benchmarking with North American TB programs. Cases are classified as low, medium or high risk based on the case's acid-fast bacilli (AFB) smear results, chest x-ray findings, and symptoms. The screening guidelines incorporate the circumstances of exposure (e.g. setting and time spent together while infectious) and susceptibility of contacts.
We conducted an evaluation to assess the effectiveness and operational use of the CSPT in an applied public health setting, and to determine whether the source case infectivity rating and individual tool parameters successfully predicted the likelihood of transmission. This project was partly funded by a grant from Public Health Ontario.
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Presenter: Teresa Leung
Teresa Leung is an epidemiologist with Toronto Public Health supporting the Tuberculosis Prevention and Control Program. She is a former field epidemiologist who was placed with Vancouver Coastal Health Authority. Teresa has also worked with the Public Health Agency of Canada across several program areas, including immunization and respiratory infections, enteric outbreak management, and emergency preparedness and response.
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