Tuberculosis (TB & LTBI)

Justin Denholm, Marion Bailes, Josh Francis

Recommendations

  • Offer tests for latent TB infection (LTBI) to all people aged ≤35 years. Children 2-10 years may have had tests for LTBI as part of pre-departure screening.
  • Screening and preventive treatment for LTBI people >35 years will depend on individual risk factors and jurisdictional requirements in the particular state or territory.
  • Offer LTBI testing with the intention to offer preventive treatment and follow up.
  • Use either the Tuberculin Skin Test (TST) or blood Interferon Gamma Release Assay (IGRA) to screen for LTBI.
  • TST is preferred over IGRA for children <5 years of age.
  • A positive TST is induration of ≥10mm in adults and children from refugee-like backgrounds; or ≥5mm in the setting of severe malnutrition, HIV infection, immunosuppression, or in children who are recent contacts of active TB cases.
  • Ensure that a CXR has been performed during the migration process for those aged ≥11 years as per screening guidelines. If so, a post-arrival CXR is not required unless TST or IGRA are positive, or there are respiratory symptoms suggestive of active pulmonary TB disease.
  • Refer individuals with a positive TST or IGRA to specialist TB services for assessment and exclusion of active TB, and consideration of treatment for LTBI.

 

 

Produced by

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in consultation with

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Refugee Health Network of Australia

Endorsed by

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Funded by

The Australian Refugee Health Practice Guide received funding from the Australian Government.

Disclaimer

The information set out in the Australian Refugee Health Practice Guide (“the Guide”) is current at the date of first publication and is intended for use as a guide of a general nature only and may or may not be relevant to particular patients or circumstances. Nor is the Guide exhaustive of the subject matter. Persons implementing any recommendations contained in the Guide must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular circumstances when so doing. The statements or opinions that are expressed in the Guide reflect the views of the contributing authors and do not necessarily represent the views of the editors or Foundation House. Compliance with any recommendations cannot of itself guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional and the premises from which the health professional operates.

Whilst the information is directed to health professionals possessing appropriate qualifications and skills in ascertaining and discharging their professional (including legal) duties, it is not to be regarded as clinical advice and, in particular, is no substitute for a full examination and consideration of medical history in reaching a diagnosis and treatment based on accepted clinical practices.

Accordingly, Foundation House and its employees and agents shall have no liability (including without limitation liability by reason of negligence) to any users of the information contained in the Guide for any loss or damage (consequential or otherwise), cost or expense incurred or arising by reason of any person using or relying on the information contained in the Guide and whether caused by reason of any error, negligent act, omission or misrepresentation in the information. Although every effort has been made to ensure that drug doses and other information are presented accurately in the Guide, the ultimate responsibility rests with the prescribing clinician. For detailed prescribing information or instructions on the use of any product described herein, please consult the prescribing information issued by the manufacturer.