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Proposal to Revise the Screening Test for Latent Tuberculosis Infection in Close Contacts at Elementary Schools in Korea
Jong-Myon Bae
Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
Corresponding Author: Jong-Myon Bae ,Tel: +82-64-755-5567, Fax: +82-725-2593, Email: jmbae@jejunu.ac.kr
Received: February 24, 2019;  Accepted: May 8, 2019.
ABSTRACT
The 2018 National Guideline for Tuberculosis Control, which was published by the Korea Centers for Diseases Prevention and Control (KCDC), mandates conducting an epidemiological survey among close contacts of active tuberculosis patients at public institutions such as schools. In the procedure for these surveys, the tuberculin skin test (TST) is mandated as the screening test for latent tuberculosis infection (LTBI) in elementary school students. However, several guidelines recommend using the interferon-gamma releasing assay (IGRA) for contacts aged over 5 years with a Bacillus Calmette-Gu챕rin (BCG) vaccination history. The main reason for this is that IGRA has a higher specificity and lower false positive rate than TST. In addition, IGRA requires only a single visit to draw blood and the results are available within 24 hours. These advantages could promote cooperation from both parents and students in conducting these surveys. Thus, these findings regarding the benefits of IGRA for surveys of close contacts at elementary schools should be incorporated into the KCDC guideline.
Key words: Latent tuberculosis; Mycobacterium tuberculosis; Practice guideline; Tuberculin test; Interferon-gamma release tests
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