Tuberculosis secondary prevention: Difference between revisions
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{{further|[[Tuberculosis screening]]}} | {{further|[[Tuberculosis screening]]}} | ||
====Tuberculin Skin Test==== | =====Tuberculin Skin Test===== | ||
*Children with close contact with a TB confirmed case should be evaluated for tuberculosis infection. | *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. | *[[TST]] is the test of choice for screening for tuberculosis infection. | ||
====Interferon-Gamma Release Assays (IGRAs)==== | =====Interferon-Gamma Release Assays (IGRAs)==== | ||
*IGRAs can be used in place of (but not in addition to) TST in screening for M. tuberculosis infection. | *IGRAs can be used in place of (but not in addition to) TST in screening for M. tuberculosis infection. | ||
*IGRAs are used in screening patients with the following conditions: | *IGRAs are used in screening patients with the following conditions: | ||
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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 detection of tuberculosis disease is important to give treatment at the appropriate time and prevent complications. | ||
*All patients should be routinely asked about: | *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 of TB exposure, infection, or disease | ||
:* Symptoms or signs of TB disease | :* Symptoms or signs of TB disease | ||
Revision as of 20:12, 24 September 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Secondary prevention for tuberculosis includes methods to achieve an early diagnosis, such as tuberculin skin test (TST) and IFGA; 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)
- IGRAs can be used in place of (but not in addition to) TST in screening for M. tuberculosis infection.
- IGRAs are used in screening patients with the following conditions:
- Have received BCG vaccination
- Groups that historically have poor rates of return for TST reading.
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:[1]
- 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:[1]
- 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.