Self-Study Modules on 

Tuberculosis, 6-9

Glossary

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 

Division of Tuberculosis Elimination 

Atlanta, Georgia 

2014
Glossary— Self-Study Modules on Tuberculosis, 6–9 

2

This glossary contains the new terms listed at the beginning of Modules 6–9. 

 

active case finding— identifying unreported cases of TB disease by actively searching for 

them through, for example, laboratory and pharmacy audits 

 

adherence agreement— a written document that describes understanding between a health 

care worker and a patient regarding TB treatment adherence and completion 

 

adherence plan— a written plan that is based on the patient’s understanding and acceptance 

of the TB diagnosis and recommended treatment. It addresses barriers to adherence and 

details the method chosen to deliver treatment and monitor adherence for that specific 

patient. 

 

adherence to treatment— following the recommended course of treatment by taking all of the 

prescribed medications for the entire recommended time 

 

authorization— permission given by the patient to allow a third party to have access to the 

patient’s confidential information 

 

autonomy— the right of a patient to determine what will be done with his or her body, 

personal belongings, and personal information; this concept applies to any adult person who 

is mentally competent 

 

barriers— anything that may prevent a patient from being able to adhere to a TB treatment 

regimen 

 

case— a person with suspected or confirmed TB disease; sometimes referred to as an index 

case or index patient 

 

case conference— meetings at designated intervals for reviewing the treatment of TB patients 

currently under care. During a case conference, the case manager presents information to 

colleagues about the status of each case under medical care and the progress of the contact

investigation. 

 

case management— a strategy health departments can use to manage patient care and help 

ensure patients successfully complete treatment 

 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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case manager— a specific health care worker who is assigned primary responsibility for the 

patient 

 

case review— the systematic, regular review of a patient’s progress by the case management 

team. Case reviews should be weekly and real-time.

chain of transmission— often used to describe the circumstances and timing of transmission 

from a source case to one or more persons who develop TB disease (secondary cases). A 

chain of transmission can extend over a few months, years, or decades. Cases involved in the 

same chain of transmission almost always have matching genotypes (when this information is 

available). 

 

clinic-based directly observed therapy (DOT)— DOT that is delivered in a TB clinic or 

comparable healthcare facility 

 

cohort review— the systematic review of the management of a specific cohort of TB patients 

and their contacts. A “cohort” is a group of TB cases counted over a specific period of time, 

usually 3 months. 

 

confidentiality— the protection of all patient information, including patient records and 

information discussed or identified during patient-health care worker encounters 

 

congregate setting— a setting in which a group of persons reside, meet, or gather either for a 

limited or extended period of time in close physical proximity. Examples include prisons, 

nursing homes, schools, and homeless shelters. 

 

contacts— persons exposed to someone with infectious TB disease, can include family 

members, roommates or housemates, close friends, coworkers, classmates, and others 

 

contact investigation— a systematic process to identify persons (contacts) who were exposed 

to someone with infectious TB disease; assess contacts for infection with M. tuberculosis and 

TB disease; and provide contacts with treatment for latent TB infection or TB disease, if 

necessary 

 

court order— an order issued by a court mandating an action such as compliance with 

directly observed therapy (DOT) or, in very rare cases, detention in a facility until treatment is 

completed 

 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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court-ordered directly observed therapy (DOT)— DOT that is administered to a patient by 

order of a public health official or a court with the appropriate authority 

 

cultural competence— having the capacity to function effectively as an individual and an 

organization within the context of the cultural beliefs, behaviors, and needs presented by 

patients and their communities 

 

data security— protection of public health data and information systems to prevent 

unauthorized release of identifying information and accidental loss of data or damage to the 

systems. Security measures include measures to detect, document, and counter threats to 

data confidentiality or the integrity of data systems. 

 

degree of infectiousness— physical or environmental characteristics that can affect ability to 

transmit M. tuberculosis

 

descriptive epidemiology— the aspect of epidemiology concerned with organizing and 

summarizing health-related data according to person, place, and time

 

discharge planning— the preparation for continued and comprehensive care of a patient after 

that patient’s discharge from a hospital or institution 

 

disclosure— the act of revealing or distributing personal information 

 

electronic directly observed therapy (eDOT)— DOT that is delivered remotely (e.g., over a 

smartphone, tablet, or computer). eDOT can either be real-time or recorded. 

 

enablers— things that make it possible or easier for patients to receive treatment by 

overcoming barriers 

epidemic curve (epi curve)— a graph that displays the number of TB cases and when they 

were identified. Time is plotted on the horizontal x-axis and the number of cases is plotted 

on the vertical y-axis. 

 

epidemiologic link (epi link)— characteristic(s) TB patients share that explains where and 

when TB could have been transmitted between them 

 

exposure period— the timeframe during which a contact may have been infected with M. 

tuberculosis

 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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field visit— visiting a TB case’s residence, congregate settings, and other places where the TB 

case spent time while infectious. A field visit can also be used to locate or meet contacts. 

 

field-based directly observed therapy (DOT)— DOT that is delivered in a setting outside of the 

TB clinic or healthcare facility 

 

genotype— distinct genetic pattern of an organism 

 

genotype cluster— when two or more cases have matching genotypes 

 

genotyping— a laboratory-based method that can determine the genetic pattern of the strain 

of M. tuberculosis that caused TB disease in a person 

 

Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule— provides national 

standards for protecting the privacy of health information. The Privacy Rule regulates how 

organizations and health care workers use and disclose certain individually identifiable health 

information. 

 

incentives— small rewards given to patients to encourage them to either take their medicine 

or keep their clinic or field DOT appointments 

 

index case— the initial TB case that prompts a contact investigation 

 

infectious— refers to a disease that is capable of being spread; a person who has infectious 

TB disease expels droplets containing M. tuberculosis into the air when he or she coughs, 

sneezes, speaks, or sings 

 

infectious period— time during which a TB case is potentially capable of transmitting M. 

tuberculosis

 

location-based investigation— an approach for conducting contact investigations onsite at a 

location where the TB case spent time while infectious. The purpose is to identify and assess 

potential TB contacts at that location. 

 

nonadherence— a patient’s inability or refusal to take TB drugs as prescribed 

 

open-ended questions— a question that cannot be answered with a simple “yes” or 

“no.” Open-ended questions are designed to elicit the patient’s knowledge, feelings, and 

beliefs. 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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outbreak case definition— a standard set of criteria for deciding which TB cases could be 

involved in an outbreak 

 

outbreak hypotheses— theories about how, when, and where TB transmission may have 

occurred during an outbreak 

 

outbreak line list— summary of the cases that meet the outbreak case definition 

 

passive case reporting— required reporting of suspected or confirmed TB cases to a public 

health authority 

 

patient assessment— talking to a patient about his or her medical history, knowledge about 

TB, and beliefs about TB treatment 

 

patient-identifiable information— information in which the identity of the patient is directly 

included or can be deduced 

 

pre-interview phase— reviewing existing information about the TB case before the first 

interview; typically this is the first step in the systematic approach to contact investigation 

 

prevalence of TB infection— the percentage of persons infected with M. tuberculosis within a 

defined population 

 

priority contacts— contacts who are at most risk for TB infection or disease 

 

privileged information— personal information shared by the patient with a health care worker 

 

protected health information (PHI)— individually identifiable health information that is 

transmitted or maintained in a database; this can be electronic media or any other form or 

medium. The protected information must relate to 1) the past, present, or future physical or 

mental health condition of an individual; 2) provision of health care to an individual; or 3) 

payment for the provision of health care to an individual. If the information identifies or 

provides a reasonable basis to believe it can be used to identify an individual, it is considered 

individually identifiable health information.

 

proxy— a person interviewed in place of a TB case. Potential proxies include family members, 

close friends, or other persons who know the person well. A proxy is used if the TB case is 

deceased, physically or mentally unable to participate in interviews, very young, or unable to 

be located. 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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proxy interview— an interview with persons (proxies) who are familiar with the TB case’s 

practices, habits, and behaviors 

 

quality assurance— the review and evaluation of the quality of care and effectiveness of the 

TB program 

 

recent transmission— transmission of TB that has occurred in the recent past, as opposed to 

reactivation of latent TB infection. Although the precise time period is not well defined, 

“recent” transmission is often considered to be within the last 2 years. 

 

secondary case— an instance of TB after a known exposure, usually related to the index case 

in an investigation 

 

secondary transmission— when any of the secondary case’s contacts are found to have latent 

TB infection or TB disease 

 

security— protection of public health data and information systems to prevent unauthorized 

release of identifying information and accidental loss of data or damage to the systems. 

Security measures include measures to detect, document, and counter threats to data 

confidentiality or the integrity of data systems. 

 

source case— a person with TB disease who is responsible for transmitting M. tuberculosis to 

another person or persons 

 

source case investigation— a method used to identify a source case; usually done when a 

young child is found to have TB disease 

 

spot map— a technique for showing where cases may have been exposed to TB or where they 

may have exposed others after developing TB disease 

 

statement of disagreement— a statement filed by the patient stating there is a disagreement 

with the health care worker or institution regarding the patient’s record 

 

TB case surveillance— monitoring the occurrence of TB disease in specific geographic areas, 

populations, and time periods 

 

TB genotyping information management system (TB GIMS)— a secure CDC-sponsored online 

national database of M. tuberculosis genotyping and TB case information 

 
Glossary— Self-Study Modules on Tuberculosis, 6–9 

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TB health care worker— any person who cares for and manages TB patients, including 

physicians, nurses, case managers, outreach workers, hospital discharge planners, 

pharmacists, social workers, peer educators, and volunteers

TB outbreak— when there are more TB cases than expected within a geographic area or 

population during a particular time period, and there is evidence of recent transmission of M. 

tuberculosis among those cases 

TB outbreak response— a process used by public health programs to investigate and 

intervene when a TB outbreak is suspected or confirmed 

 

TB outbreak response plan— an action plan that helps guide outbreak response 

 

third party— a person or an organization not directly involved in the patient’s care 

 

tumor necrosis factor-alpha (TNF-alpha) antagonists, inhibitors, or blockers— medications 

used to treat inflammatory or autoimmune diseases such as rheumatoid 

arthritis, Crohn’s disease, psoriatic arthritis, and juvenile rheumatoid arthritis 

 

waiver— a form that patients are often asked to sign to allow their health information to be 

used by third parties 

 

window period— the time between the contact’s last exposure to the TB case and when a 

tuberculin skin test (TST) or interferon-gamma release assay (IGRA) can reliably detect 

infection with M. tuberculosis

 

window period prophylaxis— treatment for latent TB infection that is given to high-risk 

contacts who have an initial negative test result for TB infection less than 8 to 10 weeks after 

their last TB exposure