COMMUNICABLE DISEASE 
CONTROL BRANCH
- Attention all doctors - 
Date: 24/03/2016     Contact telephone number: 1300 232 272  (24 hours/7 days)

 

World TB Day: Information for Medical Practitioners on Early Detection of TB

Tuberculosis (TB) is uncommon in Australia but should be readily diagnosable and treatable, although the emergence of drug resistance poses a threat. Migrants from high TB burden comprise 90% of cases in South Australia. A study conducted here between 2010 and 2014 showed greater than 50% of TB diagnoses exceeded 1 month from initial presentation and a key reason was failure to consider TB. This information is intended to provide guidance on the early detection of TB.

When to consider TB in the risk groups
> cough or persistent chest infection for more than 2 weeks ±
> other respiratory symptoms - dyspnoea, chest pain, haemoptysis and/or
> constitutional symptoms - loss of appetite, weight loss, fever, night sweats, fatigue

TB Risk Groups

Increased risk of exposure to TB Increased risk of progression from latent TB infection
(LTBI) to TB disease
  • Migrants, refugees or students from high TB burden countries (HBC)
  • Close contacts of an infectious TB case
  • Aboriginal Australians
  • Australian born pre 1960s
  • Health workers who have worked in HBC
  • Infants and children under 5 with a positive Mantoux
  • “old healed” TB on CXR
  • Immunosuppressive disorders e.g. HIV or those requiring prolonged use of corticosteroids or other immunosuppressive agents such as TNF-α antagonists
  • Solid organ transplants
  • Medical disorders such as diabetes, chronic renal disease, silicosis


Tests for suspected pulmonary TB
> chest x-ray – atypical findings are common in the immune-suppressed; consider a CT chest
> sputum testing – request 3 sputum specimens (early morning) for “AFBs”.

If the sputum result is:
> smear positive - urgently refer for isolation and treatment.
> smear negative - specialist advice should be sought; culture can take 3-6 weeks to confirm TB.

NB: The Mantoux skin test and Quantiferon gold TB assay are not routinely recommended for the investigation of active TB as they cannot distinguish active from latent infection.

For further advice please contact the South Australian TB Services at the RAH Chest Clinic on 8222 4867. Patient services are provided free of charge.

Dr Ann Koehler - Director, Communicable Disease Control Branch
For updated information on notifiable diseases in South Australia see
www.sahealth.sa.gov.au/NotifiableDiseaseReporting

Download the official health alert here (PDF)
 

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