Tuberculosis secondary prevention: Difference between revisions
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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. | *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)==== | ||
*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 | |||
:*A patient has 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 preferred compared to IGRA for TB screening due to its low cost and high accessibility.<ref>{{Cite journal | *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]] | | 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]] | ||
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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:<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 of TB exposure, infection, or disease | ||
:* Medical conditions that increase their risk for TB 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> | *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]] | :*[[Cough]] for ≥3 weeks | ||
:* Unexplained [[weight loss]] | :*[[Loss of appetite]] | ||
:* [[Night sweats]] | :*Unexplained [[weight loss]] | ||
:* [[Hemoptysis]] | :*[[Night sweats]] | ||
:* [[Hoarseness]] | :*[[Hemoptysis]] | ||
:* [[Fever]] | :*[[Hoarseness]] | ||
:* [[Fatigue]] | :*[[Fever]] | ||
:* [[Chest pain]] | :*[[Fatigue]] | ||
:* Patient from an endemic area of TB | :*[[Chest pain]] | ||
:*Patient from an endemic area of TB | |||
===Prompt Treatment=== | ===Prompt Treatment=== | ||
*Empiric therapy should be started as soon as a patient has tuberculosis disease confirmed. | *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. | *Sputum specimens should be sent for culture and [[DST]] before starting treatment. | ||
Revision as of 05:36, 29 January 2021
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Tuberculosis Microchapters |
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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 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 has 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.
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".