Tuberculosis secondary prevention: Difference between revisions
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====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> | *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 | :*A patient have received BCG vaccination | ||
:*Groups that historically have poor rates of return for TST reading. | :*Groups that historically have poor rates of return for TST reading. | ||
*TST is still the test of choice for TB screening, and IGRA is not recommended routinely. | *TST is still the test of choice for TB screening, and IGRA is not recommended routinely. | ||
Revision as of 20:26, 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)
- 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 is still the test of choice for TB screening, and IGRA is not recommended routinely.
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:[2]
- 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:[2]
- 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.