Guidelines on the Prevention and Control of Tuberculosis in Ireland

More documents

Recommendations

Info

<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCContentsNational TB Advisory CommitteeTerms of referenceForewordKey recommendationsvviiviiiix1. Epidemiology and Surveillance of Tuberculosis...................................................................11.1 Global trends........................................................................................................................... 11.2 Tuberculosis in Europe............................................................................................................. 21.3 Tuberculosis in Ireland............................................................................................................. 31.4 Surveillance of TB.................................................................................................................... 51.5 Notification Procedures........................................................................................................... 71.6 Mycobacterium Bovis.............................................................................................................. 91.7 Non-Tuberculous Mycobacteria............................................................................................. 102. Methods of Tuberculosis Screening............................................................................... 112.1 Definition of Active TB........................................................................................................... 112.2 Definition of Latent TB Infection .......................................................................................... 112.3 Tuberculin Skin Test............................................................................................................... 112.4 Factors Affecting the Result of the Tuberculin Skin Test....................................................... 152.5 Conversion and Boosting...................................................................................................... 162.6 Interferon-Gamma Release Assays (IGRA)............................................................................. 182.7 Interpretation of TST and IGRA Results................................................................................ 222.8 Chest X-Ray........................................................................................................................... 223. Management of Latent TB Infection.............................................................................. 263.1 Epidemiology of LTBI............................................................................................................. 263.2 Risk factors for LTBI............................................................................................................... 273.3 Selecting People for Treatment of LTBI................................................................................. 293.4 Treatment of LTBI................................................................................................................... 313.5 Treatment of Multidrug-Resistant or XDR LTBI..................................................................... 333.6 Pre-treatment Evaluation....................................................................................................... 343.7 Drug Regimens for LTBI......................................................................................................... 363.8 Risk of TB Associated with the Use of TNF- α Antagonists.................................................. 414. Laboratory Diagnosis of Tuberculosis............................................................................ 444.1 Role and Goals of the Modern TB Laboratory...................................................................... 444.2 Specimens.............................................................................................................................. 464.3 Specimen Processing............................................................................................................. 484.4 Processing of Positive Cultures............................................................................................. 514.5 False Positive Cultures........................................................................................................... 534.6 Interferon Gamma Release Assays (IGRA)............................................................................. 544.7 Laboratory Safety.................................................................................................................. 564.8 Quality Assurance.................................................................................................................. 585. Clinical Management..................................................................................................... 605.1 Diagnosis............................................................................................................................... 605.2 Supervision of TB Treatment................................................................................................. 625.3 Role of Public Health Staff in Clinical Management.............................................................. 635.4 Treatment of Tuberculosis...................................................................................................... 645.5 Inpatient or Outpatient Management................................................................................... 705.6 Adherence and Directly Observed Therapy (DOT)............................................................... 715.7 Legislation.............................................................................................................................. 736. Infection Prevention and Control.................................................................................. 746.1 Classification of Risk of Procedures in Healthcare................................................................. 746.2 Definition of an Infectious TB Case....................................................................................... 746.3 Administrative Aspects.......................................................................................................... 756.4 Standard Precautions............................................................................................................. 756.5 Airborne Precautions............................................................................................................. 766.6 Discontinuation of Airborne Precautions............................................................................... 84-iii-
<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSC6.7 Discharging Patients with TB from Hospital.......................................................................... 846.8 Education............................................................................................................................... 867. BCG Vaccination............................................................................................................ 887.1 Clinical Efficacy...................................................................................................................... 887.2 Criteria for Discontinuation of a Universal BCG Vaccination Programme............................. 887.3 Dose and Route of Administration........................................................................................ 907.4 Indications for BCG Vaccine.................................................................................................. 907.5 Contraindictions.................................................................................................................... 917.6 Interactions............................................................................................................................ 927.7 Administration of BCG Vaccination....................................................................................... 927.8 Immunisation Reaction and Care of the Immunisation Site.................................................. 927.9 Adverse Reactions................................................................................................................. 927.10 Tuberculin Testing prior to BCG Immunisation...................................................................... 938. Contact Tracing............................................................................................................. 948.1 Factors Predicting TB Transmission....................................................................................... 948.2 Initiating the Contact Investigation....................................................................................... 968.3 Investigating the Index Case................................................................................................. 978.4 Prioritisation of Contacts....................................................................................................... 988.5 The Contact Tracing Interview............................................................................................... 998.6 Screening Tools.................................................................................................................... 1008.7 TB Outbreaks....................................................................................................................... 1058.8 Congregate Settings........................................................................................................... 1068.9 Workplaces.......................................................................................................................... 1068.10 Hospitals and other Healthcare Settings............................................................................. 1068.11 Schools ............................................................................................................................... 1088.12 Transportation...................................................................................................................... 1098.13 Prisons ............................................................................................................................... 1108.14 Other High Risk Settings..................................................................................................... 1118.15 Incorporating New Approaches to Contact Tracing........................................................... 1118.16 Evaluation of Contact Tracing.............................................................................................. 1128.17 Mycobacterium bovis.......................................................................................................... 1129. Screening in Special Situations................................................................................... 1139.1 Healthcare Workers............................................................................................................. 1139.2 New Entrants to Ireland....................................................................................................... 1179.3 Prisons, Remand and Detention Centres............................................................................ 1199.4 Homeless Individuals........................................................................................................... 12210. TB and HIV Infection................................................................................................... 12410.1 Epidemiology and Surveillance of TB Infection................................................................... 12410.2 Pathophysiology.................................................................................................................. 12410.3 Diagnosis of TB in HIV-infected Cases................................................................................ 12510.4 Diagnosis of HIV in TB Cases............................................................................................... 12610.5 Screening for LTBI................................................................................................................ 12610.6 Treatment of Active Disease................................................................................................ 12710.7 Treatment of LTBI in HIV-Positive Individuals...................................................................... 12710.8 Evaluation of a TB/HIV Case................................................................................................ 12810.9 Prevention and Control....................................................................................................... 13011. Education, Research and Information......................................................................... 13211.1 Education............................................................................................................................. 13211.2 Research.............................................................................................................................. 13211.3 Information.......................................................................................................................... 133REFERENCES ...............................................................................................................................134LIST OF APPENDICES................................................................................................................... 156GLOSSARY OF TERMS................................................................................................................. 188-iv-
Page 2 and 3: Guidelines on the
Page 54 and 55:
BGuidelines on the
Page 56 and 57:
Guidelines on the
Page 58 and 59:
Guidelines on the
Page 60 and 61:
Guidelines on the
Page 62 and 63:
Guidelines on the
Page 64 and 65:
Guidelines on the
Page 66 and 67:
Guidelines on the
Page 68 and 69:
Guidelines on the
Page 70 and 71:
1♦Guidelines on
Page 72 and 73:
Guidelines on the
Page 74 and 75:
Guidelines on the
Page 76 and 77:
Guidelines on the
Page 78 and 79:
Guidelines on the
Page 80 and 81:
Guidelines on the
Page 82 and 83:
Guidelines on the
Page 84 and 85:
Guidelines on the
Page 86 and 87:
Guidelines on the
Page 88 and 89:
Guidelines on the
Page 90 and 91:
Guidelines on the
Page 92 and 93:
Guidelines on the
Page 94 and 95:
Guidelines on the
Page 96 and 97:
Guidelines on the
Page 98 and 99:
Figure 6.1Patient placement for Pul
Page 100 and 101:
Guidelines on the
Page 102 and 103:
Guidelines on the
Page 104 and 105:
Guidelines on the
Page 106 and 107:
Guidelines on the
Page 108 and 109:
Guidelines on the
Page 110 and 111:
Guidelines on the
Page 112 and 113:
Guidelines on the
Page 114 and 115:
Guidelines on the
Page 116 and 117:
Guidelines on the
Page 118 and 119:
Guidelines on the
Page 120 and 121:
Guidelines on the
Page 122 and 123:
Guidelines on the
Page 124 and 125:
Guidelines on the
Page 126 and 127:
Guidelines on the
Page 128 and 129:
Guidelines on the
Page 130 and 131:
Guidelines on the
Page 132 and 133:
Guidelines on the
Page 134 and 135:
Guidelines on the
Page 136 and 137:
Guidelines on the
Page 138 and 139:
Guidelines on the
Page 140 and 141:
Guidelines on the
Page 142 and 143:
Guidelines on the
Page 144 and 145:
Guidelines on the
Page 146 and 147:
Guidelines on the
Page 148 and 149:
Guidelines on the
Page 150 and 151:
Guidelines on the
Page 152 and 153:
Guidelines on the
Page 154 and 155:
Guidelines on the
Page 156 and 157:
Guidelines on the
Page 158 and 159:
Guidelines on the
Page 160 and 161:
Guidelines on the
Page 162 and 163:
Guidelines on the
Page 164 and 165:
Guidelines on the
Page 166 and 167:
Guidelines on the
Page 168 and 169:
Guidelines on the
Page 170 and 171:
Guidelines on the
Page 172 and 173:
Guidelines on the
Page 174 and 175:
Guidelines on the
Page 176 and 177:
Guidelines on the
Page 178 and 179:
Guidelines on the
Page 180 and 181:
Guidelines on the
Page 182 and 183:
Guidelines on the
Page 184 and 185:
Guidelines on the
Page 186 and 187:
Guidelines on the
Page 188 and 189:
Guidelines on the
Page 190 and 191:
Guidelines on the
Page 192 and 193:
Guidelines on the
Page 194 and 195:
Guidelines on the
Page 196 and 197:
Guidelines on the
Page 198 and 199:
Guidelines on the
Page 200 and 201:
Guidelines on the
Page 202 and 203:
Guidelines on the
Page 204 and 205:
Guidelines on the
Page 206 and 207:
Guidelines on the
Page 208 and 209:
Guidelines on the
Page 210 and 211:
Guidelines on the
Page 212 and 213:
Guidelines on the
Page 214 and 215:
Guidelines on the
Page 216 and 217:
Guidelines on the
Page 218:
25-27 Middle Gardiner Street Dublin
show all

Guidelines on the Prevention and Control of Tuberculosis in Ireland

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?