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- Title
Management of Latent Tuberculosis Infections in Australia and New Zealand: A Review of Current Practice.
- Authors
Denholm, Justin T.; McBryde, Emma S.
- 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 commonclinical 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-? 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.
- Subjects
TUBERCULOSIS diagnosis; TUBERCULOSIS prevention; MYCOBACTERIUM tuberculosis; HEPATOTOXICOLOGY; INTERFERONS; CLINICAL trials; THERAPEUTICS
- Publication
Tuberculosis Research & Treatment, 2010, p1
- ISSN
2090-150X
- Publication type
Article
- DOI
10.1155/2010/284028