Tuberculosis secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary prevention for tuberculosis | Secondary prevention for [[tuberculosis]] refers to the methods that are used for [[screening]] and early [[diagnosis]], such as [[tuberculin skin test]] (TST) and [[IGRAs]]; as well as ensuring that the right treatment regimen is given at the right time to prevent disease [[progression]]. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
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=====Tuberculin Skin Test===== | =====Tuberculin Skin Test===== | ||
* | *Evaluation of children who are having close contact with a confirmed case of [[Tuberculosis|TB]]. | ||
*[[TST]] is the test of choice for screening for | *[[TST]] is the test of choice for [[Screening test|screening]] for [[Tuberculosis|TB]] infection. | ||
====Interferon-Gamma Release Assays (IGRAs)==== | ====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> | *[[Interferon-γ release assays|IGRA]] can be used in place of (but not in addition to) [[Mantoux test|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 has received BCG vaccination | :*A patient has received [[BCG]] vaccination | ||
:* | :*Groups with poor follow up return for [[Mantoux test|TST]] reading | ||
*TST | *[[Mantoux test|TST]] is favored over [[Interferon-γ release assays|IGRA]] for [[Tuberculosis|TB]] [[screening]] due to its low cost and high availability<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]] | | 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 | | title = Comparing interferon-gamma release assays to tuberculin skin test in thai children with tuberculosis exposure | ||
| Line 38: | Line 38: | ||
===Early Diagnosis=== | ===Early Diagnosis=== | ||
*Early | *Early [[diagnosis]] of tuberculosis disease is essential to give the right [[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> | *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 | :*[[History and Physical examination|History]] of [[Tuberculosis|TB]] exposure, [[infection]], or [[disease]] | ||
:*Symptoms or signs of TB disease | :*[[Symptom|Symptoms]] or [[signs]] of [[Tuberculosis|TB]] disease | ||
:*Medical conditions that increase their risk for TB disease | :*Medical conditions that increase their risk for [[Tuberculosis|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> | *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 | :*[[Cough]] for ≥3 weeks | ||
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:*[[Fatigue]] | :*[[Fatigue]] | ||
:*[[Chest pain]] | :*[[Chest pain]] | ||
:*Patient from an endemic area of TB | :*Patient from an [[Endemic (epidemiology)|endemic]] area of TB | ||
===Prompt Treatment=== | ===Prompt Treatment=== | ||
*Empiric therapy should be started | *[[Empiric therapy]] should be started once the diagnosis of [[Tuberculosis|TB]] is confirmed. | ||
*Sputum specimens should be sent for culture and [[DST]] before | *[[Sputum]] [[specimens]] should be sent for [[Culture media|culture]] and [[DST]] before initiation of therapy | ||
==References== | ==References== | ||
Latest revision as of 05:08, 27 March 2021
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Tuberculosis Microchapters |
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Case Studies |
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Tuberculosis secondary prevention On the Web |
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American Roentgen Ray Society Images of Tuberculosis secondary prevention |
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Risk calculators and risk factors for Tuberculosis secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mashal Awais, M.D.[2]; Alejandro Lemor, M.D. [3]
Overview
Secondary prevention for tuberculosis refers to the methods that are used for screening and early diagnosis, such as tuberculin skin test (TST) and IGRAs; as well as ensuring that the right treatment regimen is given at the right time to prevent disease progression.
Secondary Prevention
Screening
Tuberculin Skin Test
- Evaluation of children who are having close contact with a confirmed case of TB.
- TST is the test of choice for screening for TB 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]
Early Diagnosis
- Early diagnosis of tuberculosis disease is essential to give the right treatment at the appropriate time and prevent complications.
- All patients should be routinely asked about:[3]
- 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 once the diagnosis of TB is confirmed.
- Sputum specimens should be sent for culture and DST before initiation of therapy
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".