|Organization:||Bureau of Infectious Disease and Laboratory Sciences|
U.S. Preventive Services Task Force Recommendation Statement Latent Tuberculosis Infection: Screening
Recommendations for Preventive Pediatric Health Care
In September 2016, the United States Preventive Services Task Force (USPSTF) published The Final Recommendation Statement on testing for latent tuberculosis (TB) infection, also referred to as LTBI. The USPSTF recommends and assigns a “B” grade to the following clinical preventive service:
|Population||Asymptomatic adults at increased risk for infection|
|Recommendation||Screen for latent tuberculosis infection|
A “B” grade means that providers will have increased opportunities to seek reimbursement for the service. Screening for latent TB infection will be covered by most private and public health insurance in 2018. The Affordable Care Act (ACA) requires that private insurance plans cover USPSTF recommendations that receive an “A” or “B” grade, and to do so without patient co-payment or deductibles.
The USPSTF recommendation applies to adult patients. The complementary pediatric recommendation for risk-based latent TB infection testing is included in the Recommendations for Preventive Pediatric Health Care published by Bright Futures and the American Academy of Pediatrics (AAP), based on recommendations of the Committee on Infectious Diseases, published in the AAP “Red Book”.
The Massachusetts Department of Public Health (MDPH) strongly endorses screening for latent TB infection in primary care due to the individual and public health benefits associated with identification of persons infected with TB and linkage with medical evaluation and treatment services.
Key recommendations for screening patients for latent TB infection include:
- Use a TB Risk Assessment to identify patients at increased risk for infection.
- Choose a diagnostic test for TB infection that is appropriate for your patient.
- Provide patients who test positive for TB infection with medical evaluation to rule out active TB disease or refer such patients for such evaluation.
- Report cases of latent TB infection or active TB disease to MDPH.
- Review treatment options and focus on shorter regimens.
- Provide education and adherence support to assist patients in completing treatment for latent TB infection.
This MDPH Advisory will review each of these elements and provide links to resources and additional information.