Management of Latent Tuberculosis Infections in Australia and New Zealand: A Review of Current Practice. (21st December 2010)

• Record Type: Journal Article
• Authors: Denholm, Justin T.; McBryde, Emma S.
• Other Names: Starke Jeffrey R. Academic Editor.
• Is Part Of: Tuberculosis research and treatment. Volume 2010(2010)
• Publication Date: 2010-12-21
• Subjects: Tuberculosis -- Periodicals; Tuberculosis -- Prevention -- Periodicals; Tuberculosis -- Treatment -- Periodicals; Tuberculosis -- Social aspects -- Periodicals; 616.995005
• DOI: 10.1155/2010/284028
• Languages: English
• ISSNs: 2090-150X

Abstract

Abstract : Aim : To survey practices in the diagnosis and management of latent tuberculosis infection (LTBI) in Australia and New Zealand. Methods : Infectious diseases and respiratory physicians and trainees were invited to complete an online questionnaire concerning various aspects of LTBI management. Results : The questionnaire was completed by 126 clinicians self-reporting regular management of LTBI. Respondents were experienced physicians, with 95/126 (75.4%) having managed LTBI for more than 5 years. Forty-seven (37.3%) reported seeing more than 5 patients per month for assessment of LTBI. Substantial variation among clinicians was reported in relation to a number of common clinical scenarios. For instance, while 52/126 (43.7%) informed patients that the incidence of severe hepatotoxicity related to isoniazid monotherapy was 0.1–0.5%, 21/126 (15.7%) thought it was > 5%. 36/126 (28.6%) clinicians would proceed with TNF- α therapy following an indeterminate screening: interferon- γ assay, while 78/126 (61.9%) would perform further investigations and 12/126 (9.5%) would initiate isoniazid therapy. Follow-up intervals during therapy varied from 1–3 monthly, with liver function testing performed routinely by 89/126 (70.6%). Conclusion : This study demonstrated a large degree of variation in clinical practice of LTBI management in Australia and New Zealand. Strategies for increasing uniformity of practice are required, including improved guidelines and physician education.