Tuberculosis secondary prevention: Difference between revisions

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{{Tuberculosis}}
{{Tuberculosis}}
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==Overview==
==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 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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{{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.
*[[TST]] is the test of choice for screening for tuberculosis infection.


====Chest X-ray====
*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)====
*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:
*[[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>
:*Have received BCG vaccination
 
:*Groups that historically have poor rates of return for TST reading.
:*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]]
| title = Comparing interferon-gamma release assays to tuberculin skin test in thai children with tuberculosis exposure
| journal = [[PloS one]]
| volume = 9
| issue = 8
| pages = e105003
| year = 2014
| month =
| doi = 10.1371/journal.pone.0105003
| pmid = 25121513
}}</ref>


===Early Diagnosis===
===Early Diagnosis===
*Early detection of tuberculosis disease is important to give treatment at the appropriate time and prevent complications.
 
*Patients with the following characteristics should be tested for tuberculosis:
*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>
 
:*[[History and Physical examination|History]] of [[Tuberculosis|TB]] exposure, [[infection]], or [[disease]]
:*[[Symptom|Symptoms]] or [[signs]] of [[Tuberculosis|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>
 
:*[[Cough]] for ≥3 weeks
:*[[Loss of appetite]]
:*Unexplained [[weight loss]]
:*[[Night sweats]]
:*[[Hemoptysis]]
:*[[Hoarseness]]
:*[[Fever]]
:*[[Fatigue]]
:*[[Chest pain]]
:*Patient from an [[Endemic (epidemiology)|endemic]] area of TB
 
===Prompt 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==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Disease]]
[[Category:Disease]]
[[Category:Infectious disease]]
[[Category: Pulmonology]]
[[Category:Pulmonology]]
[[Category:Primary care]]
[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
{{WH}}
{{WS}}

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

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".

Template:WH Template:WS