Tuberculosis (TB) is a serious bacterial infection that primarily affects the lungs but can impact other parts of the body, including the brain and kidneys. This airborne disease spreads when an infected person coughs or sneezes, releasing bacteria into the air. A TB risk assessment serves as a tool to identify individuals who may have been exposed to TB bacteria or who are at risk of developing active TB disease. This proactive approach is important for public health efforts aimed at controlling the spread of the infection.
Understanding TB Risk Assessment
A TB risk assessment evaluates an individual’s likelihood of having latent TB infection (LTBI) or active TB disease. LTBI means TB bacteria are present but inactive, causing no symptoms and not spreading. Active TB disease indicates multiplying bacteria, leading to symptoms and potential transmission. The assessment’s purpose is early identification to prevent progression and further spread, guiding healthcare professionals in decisions for testing and management.
When and Why They Are Performed
TB risk assessments are conducted to prevent outbreaks and control disease spread. They are particularly important in occupational health settings where exposure risk is elevated, including for healthcare workers, correctional facility staff, and employees in homeless shelters. Healthcare personnel undergo screening upon hire to identify latent or active infections before they begin their roles, protecting both staff and patients.
Assessments are also recommended for individuals with specific risk factors. These include people who have had close contact with someone diagnosed with active TB. Individuals born in or who have traveled for extended periods to countries where TB is more common are also considered for assessment. People with compromised immune systems, such as those with HIV, diabetes, or those receiving immunosuppressive medications, face a greater risk of developing active TB if infected.
Components of a TB Risk Assessment
A TB risk assessment involves gathering information about an individual’s health and exposure history. Healthcare providers review symptoms that could indicate active TB, such as a cough lasting more than three weeks, unexplained fever, night sweats, or unintentional weight loss. They also inquire about any past or current exposure to someone with active TB disease, including living with or spending significant time with an infected person.
A medical history is collected, covering prior TB testing or treatment, and identifying conditions that might weaken the immune system, such as HIV/AIDS, organ transplants, or the use of certain medications. Based on this information, healthcare providers may recommend TB tests, such as a TB skin test (TST) or a TB blood test (IGRA), to determine if TB bacteria are present.
What Happens After an Assessment
Following a TB risk assessment, subsequent steps depend on the identified level of risk. If the assessment indicates a low probability of TB exposure or infection, no further action may be necessary. For individuals at risk or with symptoms, additional diagnostic testing is recommended.
These tests can include a chest X-ray for lung abnormalities consistent with active TB, or sputum tests if active disease is suspected. If latent TB infection or active TB disease is confirmed, appropriate treatment and follow-up care are initiated to prevent further transmission. This ensures individuals receive necessary medical intervention to protect their health and the wider community.