Multi-drug-resistant tuberculosis secondary prevention: Difference between revisions
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__NOTOC__ | |||
{{Multi-drug-resistant tuberculosis}} | |||
{{CMG}}; {{AE}} {{AL}} | |||
==Overview== | |||
Secondary prevention for tuberculosis includes methods for screening and early diagnosis, such as [[tuberculin skin test]] (TST) and [[IGRAs]]; and to guarantee the correct treatment regimen at the right time to prevent disease progression. | |||
==Secondary Prevention== | |||
===Screening=== | |||
{{further|[[Tuberculosis screening]]}} | |||
=====Tuberculin Skin Test===== | |||
*Children with close contact with a TB confirmed case should be evaluated for tuberculosis infection. | |||
*[[TST]] is the test of choice for screening for tuberculosis infection. | |||
====Interferon-Gamma Release Assays (IGRAs)==== | |||
*IGRA can be used in place of (but not in addition to) TST in screening for [[M. tuberculosis]] infection in the following conditions:<ref name="CDC TST">{{cite web|url= http://www.cdc.gov/tb/publications/factsheets/testing/IGRA.htm|title= CDC Interferon-Gamma Release Assays (IGRAs) - Blood Tests for TB Infection }}</ref> | |||
:*A patient have received BCG vaccination | |||
:*Groups that historically have poor rates of return for TST reading. | |||
*TST preferred compared to IGRA for TB screening due to its low cost and high accessibility.<ref>{{Cite journal | |||
| author = [[Hong-Van Tieu]], [[Piyarat Suntarattiwong]], [[Thanyawee Puthanakit]], [[Tawee Chotpitayasunondh]], [[Kulkanya Chokephaibulkit]], [[Sunee Sirivichayakul]], [[Supranee Buranapraditkun]], [[Patcharawee Rungrojrat]], [[Nitiya Chomchey]], [[Simon Tsiouris]], [[Scott Hammer]], [[Vijay Nandi]] & [[Jintanat Ananworanich]] | |||
| title = Comparing interferon-gamma release assays to tuberculin skin test in thai children with tuberculosis exposure | |||
| journal = [[PloS one]] | |||
| volume = 9 | |||
| issue = 8 | |||
| pages = e105003 | |||
| year = 2014 | |||
| month = | |||
| doi = 10.1371/journal.pone.0105003 | |||
| pmid = 25121513 | |||
}}</ref> | |||
===Early Diagnosis=== | |||
*Early detection of tuberculosis disease is important to give treatment at the appropriate time and prevent complications. | |||
*All patients should be routinely asked about:<ref name="CDC Guidelines"> {{cite web| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm?s_cid=rr5417a1_e | title=CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005}} </ref> | |||
:* History of TB exposure, infection, or disease | |||
:* Symptoms or signs of TB disease | |||
:* Medical conditions that increase their risk for TB disease | |||
*Patients with the following characteristics should be tested for tuberculosis:<ref name="CDC Guidelines"> {{cite web| url=http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm?s_cid=rr5417a1_e | title=CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005}} </ref> | |||
:* [[Cough]] for ≥3 weeks | |||
:* [[Loss of appetite]] | |||
:* Unexplained [[weight loss]] | |||
:* [[Night sweats]] | |||
:* [[Hemoptysis]] | |||
:* [[Hoarseness]] | |||
:* [[Fever]] | |||
:* [[Fatigue]] | |||
:* [[Chest pain]] | |||
:* Patient from an endemic area of TB | |||
===Prompt Treatment=== | |||
*Empiric therapy should be started as soon as a patient has tuberculosis disease confirmed. | |||
*Sputum specimens should be sent for culture and [[DST]] before starting treatment. | |||
===DOTS-Plus Strategy=== | |||
*WHO has devised a new strategy to manage [[MDR-TB]] using the second line of drugs wihin the DOTS strategy in middle and low income countries. They must be implemented in well functioning national [[TB]] programs . The best way to avoid future [[MDR- TB]] epidemics is through prevention of development of future drug resistance. | |||
==References== | |||
{{reflist|2}} | |||
{{WH}} | |||
{{WS}} | {{WS}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Bacterial diseases]] | [[Category:Bacterial diseases]] | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Tuberculosis]] | [[Category:Tuberculosis]] | ||
Latest revision as of 18:07, 18 September 2017
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Multi-drug-resistant tuberculosis Microchapters |
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Differentiating Multi-drug-resistant tuberculosis from other Diseases |
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Diagnosis |
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Treatment |
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Multi-drug-resistant tuberculosis secondary prevention On the Web |
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American Roentgen Ray Society Images of Multi-drug-resistant tuberculosis secondary prevention |
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FDA on Multi-drug-resistant tuberculosis secondary prevention |
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CDC on Multi-drug-resistant tuberculosis secondary prevention |
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Multi-drug-resistant tuberculosis secondary prevention in the news |
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Blogs on Multi-drug-resistant tuberculosis secondary prevention |
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Directions to Hospitals Treating Multi-drug-resistant tuberculosis |
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Risk calculators and risk factors for Multi-drug-resistant tuberculosis secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Secondary prevention for tuberculosis includes methods for screening and early diagnosis, such as tuberculin skin test (TST) and IGRAs; and to guarantee the correct treatment regimen at the right time to prevent disease progression.
Secondary Prevention
Screening
Tuberculin Skin Test
- Children with close contact with a TB confirmed case should be evaluated for tuberculosis infection.
- TST is the test of choice for screening for tuberculosis infection.
Interferon-Gamma Release Assays (IGRAs)
- IGRA can be used in place of (but not in addition to) TST in screening for M. tuberculosis infection in the following conditions:[1]
- A patient have received BCG vaccination
- Groups that historically have poor rates of return for TST reading.
- TST preferred compared to IGRA for TB screening due to its low cost and high accessibility.[2]
Early Diagnosis
- Early detection of tuberculosis disease is important to give treatment at the appropriate time and prevent complications.
- All patients should be routinely asked about:[3]
- History of TB exposure, infection, or disease
- Symptoms or signs of TB disease
- Medical conditions that increase their risk for TB disease
- Patients with the following characteristics should be tested for tuberculosis:[3]
- Cough for ≥3 weeks
- Loss of appetite
- Unexplained weight loss
- Night sweats
- Hemoptysis
- Hoarseness
- Fever
- Fatigue
- Chest pain
- Patient from an endemic area of TB
Prompt Treatment
- Empiric therapy should be started as soon as a patient has tuberculosis disease confirmed.
- Sputum specimens should be sent for culture and DST before starting treatment.
DOTS-Plus Strategy
- WHO has devised a new strategy to manage MDR-TB using the second line of drugs wihin the DOTS strategy in middle and low income countries. They must be implemented in well functioning national TB programs . The best way to avoid future MDR- TB epidemics is through prevention of development of future drug resistance.
References
- ↑ "CDC Interferon-Gamma Release Assays (IGRAs) - Blood Tests for TB Infection".
- ↑ Hong-Van Tieu, Piyarat Suntarattiwong, Thanyawee Puthanakit, Tawee Chotpitayasunondh, Kulkanya Chokephaibulkit, Sunee Sirivichayakul, Supranee Buranapraditkun, Patcharawee Rungrojrat, Nitiya Chomchey, Simon Tsiouris, Scott Hammer, Vijay Nandi & Jintanat Ananworanich (2014). "Comparing interferon-gamma release assays to tuberculin skin test in thai children with tuberculosis exposure". PloS one. 9 (8): e105003. doi:10.1371/journal.pone.0105003. PMID 25121513.
- ↑ 3.0 3.1 "CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005".