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Tuberculosis (TB) Risk Assessment CHILD and TEEN CHECKUPS (C&TC) FACT SHEET for PRIMARY CARE PROVIDERS

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Tuberculosis (TB) Risk Assessment CHILD and TEEN CHECKUPS (C&TC) FACT SHEET for PRIMARY CARE PROVIDERS Tuberculosis (TB) Risk Assessment CHILD AND TEEN CHECKUPS (C&TC) FACT SHEET FOR PRIMARY CARE PROVIDERS C&TC Requirements Procedure General Risk Assessment A risk assessment for exposure to tuberculosis (TB) is required at 1, 6, 12 & 24 months C&TC A risk assessment tool that may be used is the visits and annually starting at age 3 years . For Minnesota Department of Health (MDH) more information refer to the Updates Latent Pediatric Tuberculosis (TB) Risk Assessment Tuberculosis Infection (LTBI) Screening and (www.health.state.mn.us). Treatment Recommendations (www.health.state.mn.us). Screening with TB Blood Test (IGRA) TB screening is only recommended for high-risk The American Academy of Pediatrics (AAP) Red children. Book (2018-2021) indicates interferon gamma release assay (IGRAs) as the primary TB Personnel screening test for patients aged 2 years and older (American Academy of Pediatrics, 2018). Tuberculin Skin Tests (TSTs) should be For more information, refer to the CDC’s IGRAs performed, read, and recorded by health care – Blood Tests for TB Infection (www.cdc.gov). workers trained in the administration and interpretation of TSTs. Screening with TB Skin Test (TST) A licensed, trained health care worker can draw TST is an acceptable alternative if a TB blood TB blood tests. A licensed health care provider test (IGRA) is unavailable, too costly, or too (physician, nurse practitioner, physician burdensome, such as mass screenings and assistant) must complete result interpretation employment screenings. and follow-up. TSTs are recommended for children under 2 Documentation years of age. A positive TST at any age is considered valid. For children 6 months of age Document the TB risk assessment result. If and older, a negative TST is considered valid. positive for risk of TB exposure, document the TSTs may be used for children < 6 months of screening test ordered and completed. The age, however, a negative TST result in a child of results, when available, must be documented this age is unreliable. MDH recommends in the patient’s record. For documentation repeating an initial negative TST in an infant examples, refer to the C&TC Documentation after the child reaches 6 months of age. Forms for Providers and Clinics (www.dhs.state.mn.us). For detailed information on administration, refer to MDH’s Tuberculin Skin Test (TST) (www.health.state.mn.us). Follow Up A positive TST or IGRA indicates a likely TB infection. A licensed health care professional TB RISK ASSESSMENT must differentiate between latent TB infection Resources (LTBI), which is non-contagious, and active TB disease. Both types of infections require Minnesota Department of Human treatment. Further medical evaluation includes Services a complete history, targeted physical examination, chest radiograph and, if indicated, ▪ C&TC Schedule of Age-Related Screening sputum cultures. Standards (www.dhs.state.mn.us) ▪ Minnesota Health Care Programs (MHCP) For further clarification of LTBI versus TB Provider Manual - C&TC Section disease, refer to the CDC’s Basic TB Facts (www.dhs.state.mn.us) (www.cdc.gov). Minnesota Department of Health Reporting ▪ Child and Teen Checkups (C&TC) Confirmed or suspected cases of active TB (www.health.state.mn.us) disease must be reported to MDH within one ▪ TB Information for Health Professionals working day of identification. Both pulmonary (www.health.state.mn.us) and extra pulmonary forms of TB disease are ▪ TB posters by language reportable. (www.health.state.mn.us) Call or fax reports to the MDH TB Prevention and Control Program (651) 201-5414 or (877) Centers for Disease Control and 676-5414. Do not wait for culture confirmation Prevention (CDC) before reporting TB. MDH provides more ▪ Tuberculosis (TB) Professional Resources information about Reporting Tuberculosis and Tools (www.cdc.gov) (www.health.state.mn.us). References Importance of Risk Assessment American Academy of Pediatrics. (2018). Red Book 2018- MN TB statistics show that in 2019, 148 new 2021 Report of the Committee on Infectious Diseases. cases of active TB were reported in Minnesota Retrieved from Red Book Online: https://redbook.solutions.aap.org/chapter.aspx?sectionId (MDH, 2020). Of these cases, 5% were pediatric =189640207&bookId=2205&resultClick=1#192304183 patients. Young children are more likely than CDC. (2018). TB in Children. Retrieved from older children and adults to develop life- https://www.cdc.gov/tb/topic/populations/tbinchildren/d threatening forms of TB disease (CDC, 2018). efault.htm MDH. (2020). TB Statistics. Retrieved from https://www.health.state.mn.us/diseases/tb/stats/index. Professional Recommendations html American Academy of Pediatrics For More Information Recommendations for Pediatric Preventive The Child and Teen Checkups (C&TC) program is Health Care (www.aap.org) indicates risk administered through a partnership between the assessment for TB exposure, followed by Minnesota Department of Human Services and the appropriate action, at the first health care Minnesota Department of Health. encounter with a child, at 6 months of age and annually at well-child visits from 12 months For questions about this fact sheet or to obtain this information in a different format, call 651-201-3760 through 20 years of age. or email [email protected]. Revised 03/2021 2 .
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