The Union Courses Online

This course enhances and complements the knowledge of the “Prevent Tuberculosis: Management of TB Infection course” that is currently available on Union Courses Online (in English, French and Spanish). Throughout this course, case studies and practical examples from different country realities will illustrate the more advanced concepts of TBI identification and care.

The course is available to all audiences as an asynchronous online learning option with a mix of educational units of about 30 min each. A variety of engaging activities such as polls, quizzes, small case studies, simulations, multiple-choice questions (where the incorrect answers highlight classic mistakes) are used to support learner engagement.

The total estimated time needed to complete the course is between 7 and 10 hours. The participant can start the course at any time, pause and come back to it at a later stage, and continue at the same point where he/she had left it.

At the end of the educational unit there is a quiz. The questions must be answered correctly for the participant to move on to the next educational unit. The participant can review the educational unit again and re-take the quiz if the questions were not answered correctly.

Further reading materials are organised by EU and can be accessed on the REFERENCES button on each EU.

EU1: Welcome to this course and IJTLD clinical standards for tuberculous infection (TBI)

• Learning objective: at the end of this EU, participants understand the context of the course, how it links with the first Union online course on TBI and what the IJTLD clinical standards and their role in TBI management are
• Topics:

1. Welcome, introduction to this course and a brief recap of the TBI course-Part I
2. IJTLD clinical standards for TBI
3. Summary/conclusion

EU2: Difference between TBI and TB disease and ruling out TB disease

• Learning objective: at the end of this EU, participants understand the basics of the TB spectrum, the difference between TBI and TB disease and how to rule out TB disease
• Topics:
  1. A brief introduction to TB pathogenesis and the difference between TBI and TB disease
  2. Diagnosis in people who present with typical (or classical) symptoms and signs of TB
  3. Atypical presentation of TB in, for example, children and immunosuppressed people; additional diagnostic tools
  4. What to do when managing people with challenging clinical presentations: examples of situations where individual management can be improved
  5. Quiz
  6. Summary

EU3: Testing for TBI

• Learning objective: at the end of this EU, participants understand the key diagnostic tools to diagnose TBI, their advantages, disadvantages and limitations
• Topics:
  1. Tuberculin Skin test (TST): the in vivo test for TBI, including the technique to administer and read TST
  2. Interferon-gamma release assay (IGRA): the in vitro test for TBI
  3. TST versus IGRA: comparison to aid decision making
  4. Test discrepancies
  5. Research and development pipeline: new tests and tools to differentiate TBI and TB disease
  6. Quiz
  7. Summary/conclusion

EU4: Management of laboratory consumables required in TBI services

• Learning objective: at the end of this EU, participants know how to manage the laboratory consumables for TBI services

Note: this EU will not include testing for active TB (sputum smear, CBNAAT, etc.) but focus on tuberculin skin test (TST) and interferon-gamma release assay (IGRA)

• Topics:

1. General principles of management of laboratory consumables
2. How to apply principles for procurement and supply chain management (PSM) in the management of laboratory consumables
3. Challenges in PSM for laboratory consumables
4. Getting tests to people and samples to the laboratory
5. Exercise
6. Summary/conclusion

EU5: Providing TB preventive treatment (TPT) and choice of the regimen, including TPT for contacts of people with drug-resistant (DR-) TB

• Learning objective: at the end of this EU, participants are familiar with the currently available treatment options for people with drug-susceptible and –resistant TB infection
• Topics:
  1. Historical evidence for TPT
  2. Current regimen options in DS-TBI
  3. Current regimen options in DR-TBI
  4. Special considerations when offering TPT to people living with HIV
  7. How to transition from 6H to new shorter regimens
  8. Quiz
  5. Summary/conclusion

EU6: Monitoring and management of adverse events, adherence and completion of TPT

• Learning objective: at the end of this EU, participants know the most frequent and concerning adverse drug events associated with TPT and their management and understand the role of management of adverse drug events in ensuring TPT adherence and completion
• Topics:
  1. Identification of common adverse drug events
  2. Management of common adverse drug events
  3. Role of adverse drug events during treatment interruption
  4. Importance of adherence to TPT and how to support people so that they will complete their treatment courses
  5. Quiz
  6. Summary/conclusion

EU7: Procurement and supply chain management (PSM) of medicines for TPT

• Learning objective: at the end of this EU, participants know the general principles of PSM and how to apply them in the management of TBI
• Topics:

1. General principles of PSM and relevance for the management of TBI
2. The link between treatments for TBI and TB
3. Quantification of TBI medicines
4. Tools for PSM for TBI medicines (QuanTB, excel)
5. Exercise
6. Summary/conclusion

EU8: Identifying and offering TBI services to populations at risk

• Learning objective: at the end of this EU, participants know key populations at risk of developing TB with a special focus on contacts of people diagnosed with TB and how contact management services could be organized and strengthened
• Topics:
  1. Identifying and offering TBI services for populations at risk, with focus on contacts of people with TB
  2. Contact management: timing of contact investigations and opportunities to find both people with presumptive TB and people who may be eligible for TPT 
  3. Examples of successful contact management initiatives
  4. Quiz
  5. Summary/conclusion

EU9: Building TBI care cascades and monitoring quality of TBI services

• Learning objective: by the end of this EU, participants are familiar with recording and reporting tools for TBI and how to assess the quality of TBI services through TBI care cascades and local use of data on TBI management
• Topics:
  1. Transitions in TBI management and role of TBI care cascades in monitoring quality of TBI services
  2. Data sources for TBI management
  3. Use of TBI data for monitoring quality of TBI services
  4. Examples of local level data use in TBI services
  5. Quiz
  6. Summary/conclusion

EU10: Integrating TBI management into data-driven support supervision

• Learning objective: by the end of this EU, participants understand the purpose of data-driven support supervision and how to apply it TBI management
• Topics:
  1. What is data-driven support supervision and what are its advantages?
  2. Purpose of data-driven support supervision and how to carry it out
  3. Role of feedback in support supervision
  4. Examples of effective support supervision
  5. Quiz
  6. Summary/conclusion

EU11: Funding requirements for TBI services and potential funding models (RD, IM)

• Learning objective: by the end of the EU, participants understand basic funding requirements and budget needs for TBI
• Topics:
  1. Basic principles of budgeting and how to apply it to planning and management of TBI
  2. Resource requirements for TBI management
  3. Budgeting tools
  4. Quiz
  5. Summary/conclusion

EU12: Integrating TBI services into programmes other than national TB programmes, for example, into national AIDS, child and maternal health, migrant health and viral hepatitis programmes; examples of successful TBI implementation/campaigns

• Learning objective: by the end of this EU, participants understand the advantages of programmatic collaboration and integrated approaches to TBI and are familiar with lessons learned of selected TBI campaigns that they may be able to adapt to their own work

•  Topics:
  1. Role of programmatic collaboration in strengthening TBI implementation
  2. From NTP and NAP implementation of TBI to implementation by other programmes, for example, child and maternal health, migrant health and viral hepatitis programmes  
  3. Examples of successful collaborative activities in TBI management
  4. Examples of TBI campaigns and lessons learned
  5. Quiz
  6. Summary/conclusion

Course evaluation

Standard questionnaire to obtain feedback from participants about the platform and quality of the course.