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Decision Tree for Investigating a Person with Contact to a Patient with Tuberculosis

Purpose: To identify a person who has had contact with a patient with tuberculosis who should be prioritized for investigation.

Description

Gerald et al developed a decision tree to help to identify a contact exposed to a patient with tuberculosis who should be investigated. This can be helpful to prioritize the investigation in a resource-limited setting. The authors are from the University of Alabama at Birmingham and the Alabama Department of Health.


Person to evaluate: someone who has had contact with a patient with tuberculosis

 

Parameters:

(1) cavity tuberculosis in the patient

(2) age of the contact

(3) total exposure time in hours per month

(4) sputum smear results of the patient

(5) place of exposure

(6) ventilation at the place of exposure

 

Contacts would be prioritized for investigation if:

(1) the patient had cavitary tuberculosis

(2) the contact is less than 15 years of age

(3) total exposure time >= 120 hours per month

(4) patient has a positive sputum smear AND exposure occurred at home

(5) patient has a positive sputum smear AND the place of exposure has minimal (poor) ventilation

 

Contacts with a low rate of PPD conversion had one of the 2 following patterns:

 

Contact Age

Cavitary TB

Exposure Time

Sputum Smear

Place of Exposure

Ventilation

>= 15 years

no

< 120 hours

negative

NA

NA

>= 15 years

no

< 120 hours

positive

not home

good

 


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Specialty

Objective

ICD-10