Tuberculosis (TB) Risk Assessment – Exploratory Measure Tip Sheet

Qhov no yog ib qho kev ntsuam xyuas; tsis muaj kev them nyiaj rau xyoo 2021 thiab 2022. Yog xav paub ntxiv, xa mus rau 2021 thiab 2022 CBI Technical Specifications.

ICD-10 Code: Z11.1: "Kev sib ntsib rau kev tshuaj ntsuam xyuas tus kab mob ua pa."

Kwv yees li ntawm 30-40% ntawm cov neeg raug tus kab mob Mycobacterium tuberculosis (TB) yuav kis tau tus kab mob.[i]. Rau cov neeg uas tau kis tus kab mob TB los yog Latent Tuberculosis Infection (LTBI) yog tias lawv mus tsis tau kho, qhov kev pheej hmoo ntawm kev tsim tus kab mob ntsws ntev ntev yog kwv yees li 5% txog 10%.[ii] Cov kws kho mob hauv tsev kho mob tuaj yeem hloov txoj hmoo ntawm cov tswv cuab kis tus kab mob TB tab sis tsis tau kho nws. Muaj 13 lab tus tib neeg kwv yees tias nyob nrog LTBI.[iii]

CDC thiab US Preventive Services Task Force (USPSTF) pom zoo tshuaj xyuas LTBI hauv cov neeg uas muaj kev pheej hmoo ntau ntxiv. Kev pheej hmoo rau tus kab mob TB feem ntau poob rau hauv ob pawg, thawj zaug lawv yuav raug cuam tshuam rau ib tus neeg muaj tus kab mob TB, lossis thib ob, lawv tus kheej muaj kev noj qab haus huv uas cuam tshuam nrog kev pheej hmoo ntau ntxiv los ntawm LTBI mus rau kab mob TB. Qee tus ntawm koj cov neeg mob yuav muaj kev pheej hmoo siab dua lwm tus suav nrog:

• Cov neeg mob los ntawm cov teb chaws uas muaj tus kab mob TB, lossis cov neeg uas tau mus rau thaj chaw no thiab siv sijhawm ib hlis lossis ntev dua nyob ntawd. Cov teb chaws suav nrog yog feem ntau lub tebchaws hauv Latin America, Caribbean, Africa, Asia, Eastern Europe, thiab Russia.
• Cov neeg mob uas tau siv sij hawm nrog ib tus neeg mob TB
• Cov neeg uas tau nyob hauv qhov chaw uas TB muaj ntau dua (xws li cov tsev tsis muaj tsev nyob, chaw kho mob, lossis tsev laus, thiab lwm yam).

Tsis tas li, kev pheej hmoo yog cov uas muaj qee yam mob:

• Cov neeg mob uas tiv thaiv kab mob los ntawm kev siv tshuaj, lwm yam kev kho mob lossis kev noj qab haus huv
• Cov neeg mob tau kuaj pom muaj ntshav qab zib mellitus
• Cov neeg mob uas tau txais kev hloov khoom nruab nrog cev
• Tsis ntev los no cov kev sim hloov pauv (txhais tau tias yog cov neeg uas muaj cov txiaj ntsig tsis zoo hauv qhov kev sim uas muaj qhov nce ntawm 10 hli lossis ntau dua hauv qhov loj ntawm Tuberculin Skin Test (TST) cov tshuaj tiv thaiv, los yog yav dhau los tau kuaj tsis zoo nrog kev kuaj ntshav TB thiab tam sim no tau kuaj pom qhov zoo hauv 2 xyoos).

[i] Centers for Disease Control and Prevention. Kev tswj tus kab mob ntsws hauv Tebchaws Meskas: cov lus pom zoo los ntawm American Thoracic Society, CDC, thiab Infectious Diseases Society of America. MMWR 2005;54(No. RR-12): 1-81. https://www.cdc.gov/mmwr/PDF/rr/rr5412.pdf

[ii] Ibid, page 12.

[iii] Teb Chaws Asmeskas Tiv Thaiv Kev Pabcuam Task Force. Kev tshuaj ntsuam xyuas kev kis tus kab mob latent tuberculosis hauv cov neeg laus: US Kev Tiv Thaiv Kev Pabcuam Task Force Daim Ntawv Pom Zoo. JAMA. 2016; 316(9): 962–969. doi: 10.1001/jama.2016.11046

• Siv cov cuab yeej ntsuas kev pheej hmoo rau cov menyuam yaus uas tsis muaj tsos mob los tshuaj xyuas kev pheej hmoo rau TB latent ua ntej kuaj. Cov cuab yeej tshuaj ntsuam pom zoo: https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/TBCB-CA-Pediatric-TB-Risk-Assessment.pdf
• Ntxiv chij rau cov ntaub ntawv kho mob hauv hluav taws xob kom ceeb toom rau kev tshuaj ntsuam xyuas txhua xyoo.
• Txheeb xyuas cov neeg mob yug txawv teb chaws thiab tshuaj xyuas lawv ua ntej cov neeg mob yug hauv Asmeskas.
• Siv cov tshuaj interferon-gamma tso tawm (IGRAs) lossis "kev kuaj ntshav" rau ib qho kev kuaj TB uas xav tau tshwj tsis yog tias nws yuav tsum tsis txhob siv rau cov menyuam yaus hnub nyoog qis dua ob xyoos.
• Tshaj tawm cov lus qhia no hauv koj lub chaw kho mob cov neeg ua haujlwm ua haujlwm: https://tinyurl.com/yys8zohg
• Tsim kom muaj kev ua haujlwm hauv tsev laus rau kev tshuaj xyuas, kuaj thiab ua raws li cov neeg mob nrog LTBI.
• Qhia cov neeg mob thiab cov neeg ua haujlwm hauv tsev kho mob txog tus kab mob TB nrog cov ntawv qhia, cov ntawv qhia, cov lus qhia thiab cov khoom siv. CDC tau tsim ntau yam kev kawm muab tso rau hauv lawv lub vev xaib, suav nrog cov ntaub ntawv xaiv uas pub dawb rau kev txiav txim: https://www.cdc.gov/tb/publications/default.htm