Tuberculosis secondary prevention: Difference between revisions

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==Overview==
==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 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=====
*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.
*Evaluation of children who are having close contact with a confirmed case of [[Tuberculosis|TB]].
*[[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>
 
:*A patient have received BCG vaccination
*[[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>
:*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
:*A patient has received [[BCG]] vaccination
:*Groups with poor follow up return for [[Mantoux test|TST]] reading
 
*[[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
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===Early Diagnosis===
===Early Diagnosis===
*Early detection of tuberculosis disease is important to give treatment at the appropriate time and prevent complications.
 
*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
 
:* Symptoms or signs of TB disease
:*[[History and Physical examination|History]] of [[Tuberculosis|TB]] exposure, [[infection]], or [[disease]]
:* Medical conditions that increase their risk for TB disease  
:*[[Symptom|Symptoms]] or [[signs]] of [[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>
:*Medical conditions that increase their risk for [[Tuberculosis|TB]] disease
:* [[Cough]] for ≥3 weeks
 
:* [[Loss of appetite]]
*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>
:* Unexplained [[weight loss]]
 
:* [[Night sweats]]
:*[[Cough]] for ≥3 weeks
:* [[Hemoptysis]]
:*[[Loss of appetite]]
:* [[Hoarseness]]
:*Unexplained [[weight loss]]
:* [[Fever]]
:*[[Night sweats]]
:* [[Fatigue]]
:*[[Hemoptysis]]
:* [[Chest pain]]
:*[[Hoarseness]]
:* Patient from an endemic area of TB
:*[[Fever]]
:*[[Fatigue]]
:*[[Chest pain]]
:*Patient from an [[Endemic (epidemiology)|endemic]] area of TB


===Prompt Treatment===
===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.
*[[Empiric therapy]] should be started once the diagnosis of [[Tuberculosis|TB]] is confirmed.
*[[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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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

Further information: [[:Tuberculosis 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]
  • A patient has received BCG vaccination
  • Groups with poor follow up return for TST reading

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]

Prompt Treatment

References

  1. ↑ "CDC Interferon-Gamma Release Assays (IGRAs) - Blood Tests for TB Infection".
  2. ↑ 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. ↑ 3.0 3.1 "CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005".

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