From: Tuberculosis in childhood: a systematic review of national and international guidelines
TST alone | IGRA alone | both TST and IGRA | |
---|---|---|---|
WHO [6] | • Any child, irrespective of HIV status, in low and middle-income countries | ||
NICE [22] | • Children younger than 5 years | • BCG vaccinated children (> 5 years of age) • Children > 5 years of age, in an outbreak situation | • Children > 5 years of age whose TST is positive |
• Children younger than 5 years • Before initiation of immunosuppressive therapy | • BCG vaccinated children (> 5 years of age) • Children > 5 years of age who are unlikely to return for TST reading • Before starting immunosuppressive therapy | • The initial and repeat IGRA are indeterminate • The initial test (TST or IGRA) is negative and: - clinical suspicion for TB disease is moderate to high - risk of progression and poor outcome is high • The initial TST is positive and: - Children > 5 years of age who have received BCG vaccine - Non-tuberculous mycobacterial disease is suspected - Additional evidence are needed to increase compliance | |
European [19] | • Children younger than 5 years • Children > 5 years who are: - not HIV-infected - not BCG vaccinated | • BCG vaccinated children (> 5 years of age) | • HIV-infected children • Before starting immunosuppressive therapy (anti-TNFalfa inhibitor therapy) |
Spanish [23] | • Any child | • The initial TST is negative and: - Immunocompromised children - High risk of infection, of progression to disease and of a poor outcome • The initial TST is positive and: - BCG vaccinated children - Risk factors are negative | |
Canadian [31] | • Whenever it is planned to repeat the test later to assess risk of new infection (i.e. conversions) | • People who have received BCG vaccination • People from groups that historically have poor rates of return for TST reading. | • High risk of infection, of progression to disease and of a poor outcome • The initial and repeat IGRA are indeterminate |