On 24 March 2011, The National Institute for Health and Clinical Excellence (NICE) published their new clinical Guidelines for TB control in England and Wales. They are available online at www.nice.org.uk and are titled ‘Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control'.
In recognition of the mounting clinical evidence in favour of IGRA technology, the new guidelines recommend going straight to an IGRA test in a number of specified indications including:
- In an outbreak situation when large numbers of individuals may need to be screened
- Recent arrivals from high incidence countries who are from 16 to 34 years old (older subjects may also be screened depending on the risk/benefits of treatment
- The immunocompromised and some HIV subjects
- New NHS employees who have recently arrived from high incidence countries or who have had contact with patients in a setting where TB is highly prevalent
- Hard to reach populations
In addition, the new guidelines recommend that an IGRA test be considered for initial use in individuals for whom Mantoux testing may be less reliable, such as those who have been BCG vaccinated, and for use in individuals whose Mantoux test result is positive.
If your laboratory is in the UK and is not yet able to provide a blood test, then send your samples to Oxford Diagnostic Laboratories National TB Testing Services.