Navy Medicine Touts Updates to Tuberculosis Control Policy

PORTSMOUTH, Va. (NNS) -- The Navy and Marine Corps Public Health Center (NMCPHC) announced April 29 that updates to Navy Medicine's policy for prevention and control of tuberculosis have improved unit readiness, increased Sailor and Marine safety, and saved millions of dollars.

The center concluded that Navy and Marine Corps personnel had lower rates of active pulmonary tuberculosis than the general U.S. population and that prevention and control of tuberculosis could be accomplished more efficiently through a limited and more targeted testing program.

According to Capt. Chris Clagett, NMCPHC Director for Preventive Medicine, an effective program to manage prevention and control of tuberculosis and keep Sailors and Marines with their units is a key factor in maintaining operational readiness.

"We've greatly reduced the effort required to affirm unit deployment readiness," said Clagett.

A key prevention strategy laid out in the Navy Medicine instruction, released Feb. 21, is prompt detection and treatment of tuberculosis. The revised testing approach, first enacted in the 2009 version of the policy, requires annual exposure risk screening during the Periodic Health Assessment (PHA) and subsequent testing only in those service members determined to be at high risk of infection with tuberculosis. This approach ultimately reduces the chances for "false positives" when administering and interpreting the Tuberculin Skin Test (TST). False positives result in increased time away from work for the Sailors and Marines, increased testing costs, and unnecessary medication costs.

Along with improved unit readiness, the cost savings to the Department of the Navy (DoN) has amounted to more than $2 million thus far. According to Clagett, significant savings can be realized through a testing program that is focused only on Sailors and Marines who are at risk, an approach that leads to savings in both costs and resources.

"This is more than just about the money. We have freed up financial resources to be applied to other things we consider important," said Clagett. "Efficiency can sometimes mean reducing ineffective expenditures of resources in order to have more for efforts that produce better results or are more valuable. With universal periodic testing we were way into the region of diminishing returns."

Starting in 2008, NMCPHC's preventive medicine team took a look at the way Navy managed its tuberculosis program.

"Thinking in the abstract, we send our people many places in the world where tuberculosis burden is greatly elevated compared to the United States; therefore, we reasoned that as military members we were at increased risk," explained Clagett.

In reality, however, the data showing how infrequently we acquire the infection argue against this.

"Based on years of data, we now know that we are not at elevated risk," said Clagett.

The center is part of the Navy Medicine team, a global healthcare network of 63,000 Navy medical personnel around the world who provide high quality healthcare to more than one million eligible beneficiaries. Navy Medicine personnel deploy with Sailors and Marines worldwide, providing critical mission support aboard ship, in the air, under the sea and on the battlefield.

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