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blood test testing

What blood test shows inflammation?

 

The blood tests that show inflammation are the C-Reactive Protein (CRP) Test, Erythrocyte Sedimentation Rate (ESR), Plasma Viscosity test(PV), and Serum Protein Electrophoresis (SPE ).

 

Inflammation is the local response of tissue to injurious agents.

What is inflammation and What blood test shows inflammation?

 

What blood test shows inflammation?

 

  • It is the local response of tissue to injurious agents. These injurious agents are:
  1. Physical agents such as temperature,
  2. Biological agents such as Bacteria, Parasites, Viruses,
  3. Chemical agents such as solvents etc.

 

The main components of inflammation are :

  • A Vascular reaction and
  • A cellular response

Both components activate by the mediators that are derived from plasma proteins and other cells.

 

What are the types of inflammation?

 

1) Acute inflammation :

  • It is defined as inflammation that occurs immediately as a response to an injury.
  • It is characterized by classical signs like heat, redness, swelling pain.
  • The acute inflammation delivers leukocytes to the site of injury.
  • Acute inflammation exists for a short duration of time.

 

2) Chronic inflammation :

  • It is defined as an inflammation that exists for a prolonged duration (week or year).
  • Such inflammation occurs at that time when acute inflammation fails in resolving the problem.

 

Mediators of inflammation

  • Mediators are produced either locally by cells or from circulating precursors that are activated at the site of inflammation.
  • A chemical mediator is defined as a substance that may be released from the cells, plasma, or damaged tissues itself.
  • The chemical mediators are broadly classified into the following types :

1. Cell-derived mediators
2. Plasma-derived mediators

 

Cardinal signs :

  • Redness (Rubor)
  • Swelling(Tumor)
  • Heat(Calor )
  • Pain(Dolar)
  • Loss of function (Functionlaesa)

 

Etiology of inflammation

  • Microbial
  • Immunological
  • Physical
  • Chemical

What blood test shows inflammation?

The blood tests that show inflammation are as follows:

 

1. C-Reactive Protein (CRP) test :

  • CRP is a protein that our liver synthesize in response to inflammation in the body.
  • CRP binds the dead or dying cells and helps in their removal.
  • There is an occurrence of a high level of CRP in your blood if you have several inflammatory diseases.
  • When you have tested for CRP and if you have elevated markers, you definitely have an indicator that some inflammation is going on in our body,
  • However, it doesn’t differentiate between acute or chronic inflammation because CRP elevates during both.

 

2. Erythrocyte Sedimentation Rate (ESR)

  • It is the simplest test.
  • For ESR test a doctor draws your blood and combines that blood with a chemical that allows red blood cells to separate from plasma.
  • The doctor observes how long it takes for RBCs to fall or to sediment in the tube that contains blood.
  • The quicker RBCs fall, the more likely that you are experiencing inflammation.

 

3. Plasma Viscosity test(PV)

  • It tests the viscosity of plasma.
  • The plasma Viscosity test measures the thickness of the blood.
  • If there is inflammation or infections occurring in our body then the plasma thickens.

 

4. Serum Protein Electrophoresis (SPE )

  • Serum Protein Electrophoresis is for the confirmation of chronic inflammation.
  • It measures some of the proteins that are present in the liquid part of the blood to determine any problems or issues.
  • If these proteins are present in too little or too much, it indicates the inflammation and also markers for other conditions.

 

Foods that fight inflammation

 

  1. Herbs and spices: Garlic, oregano, cinnamon, rosemary, turmeric, and cloves are among the many herbs and spices containing powerful antioxidants that help neutralize free radicals and prevent harm to the body.
  2. Extra virgin olive oil, nuts, and seeds: Foods high in monounsaturated fatty acids, such as olive oil, nuts, and seeds, help reduce inflammation, which lowers the risk of metabolic diseases.
  3. Leafy greens: Spinach, kale, arugula, and other green veggies are rich in Vitamin K, which suppresses inflammation markers in the body.
  4. Berries: Strawberries, blueberries, and raspberries are rich in anthocyanins, an anti-inflammatory phytochemicals.
  5. Fatty fish : Eating fatty fish , such as salmon , herring , sardines , anchovies and tuna , twice a week , provides an inflammatory omega-3 fats.

 

 

Frequently asked Questions (FAQs)

 

Can a blood test detect inflammation?

The blood tests that show inflammation are the C-Reactive Protein (CRP) Test, Erythrocyte Sedimentation Rate (ESR), Plasma Viscosity test(PV), and Serum Protein Electrophoresis (SPE ). Inflammation is the local response of tissue to injurious agents.

What are the 5 classic signs of inflammation?

Redness (Rubor), Swelling(Tumor), Heat(Calor ), Pain(Dolar), and Loss of function (Functionlaesa)

How do I know if my body has inflammation?

You have 5 cardinal signs that indicate that your body has inflammation. They are Redness (Rubor), Swelling(Tumor), Heat(Calor ), Pain(Dolar), and Loss of function (Functionlaesa)

How long can inflammation last?

Acute inflammation exists for a short duration of time whereas chronic inflammation exists for a prolonged duration (week or year).

 

Also, Read :

What blood test shows anemia?

Cardiovascular diseases examples

Can a blood test detect colon cancer?

How many kidney stones can you have?

 

 

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kidney function blood test testing

What blood test shows kidney function?

 

 

Blood tests that show kidney function tests are Serum Creatinine Test, Blood Urea Nitrogen (BUN), Estimated Glomerular Filtration Rate (eGFR, and Cystatin C concentration.

 

What do kidneys do?

 

As we know our kidneys are the necessary organs of our body. The main function of the kidneys is to the filtration of the blood.

 

The kidney filters the waste materials out of the blood with the help of nephrons that are present in our kidney.

 

The waste that is filtered by our kidneys is thrown out of our body through urine.

 

What are the results of kidney function tests?

 

1)  Plasma urea

  • Urea is a waste that the body creates.
  • A high level of urea indicates problems with kidneys.

2) Creatinine:

  • Creatinine is the waste that generates in our bodies.
  • Increased concentration in blood implies bad kidneys.
  • Creatinine level is the indicators of our renal health

3) Electrolytes level:

  • It includes the level of sodium, potassium, chlorides, bicarbonates
  • These electrolyte levels provide the dehydration status of our bodies.

 

Why it is important to perform kidney function tests?

 

  • Symptoms of kidney diseases may not be observed until as much as 30-40% of the kidney is damaged.
  • Early detection of kidney dysfunction can help to minimize future damage.
  • To diagnose the health status of kidney
  • To diagnose renal diseases and to diagnose kidney failure.
  • It checks dehydration status.

 

 

What are kidney function tests?

 

What blood test shows kidney function?

 

  • Serum creatinine
  • Blood Urea Nitrogen (BUN)
  • Estimated Glomerular Filtration Rate (eGFR)
  • 24-hour urine creatinine clearance test
  • ACR (Albumin to Creatinine Ratio)
  • Cystatin C

 

What blood test shows kidney function?

 

1. Serum Creatinine Test

Significance of creatinine

 

  • Creatinine is the waste product of creatine. Our muscles use it to make energy.
  • Creatinine moves in the blood to the kidneys and then our kidney excretes it.
  • High levels in the blood might indicate that the kidneys are not working properly.

 

Normal values of serum creatinine

 

  • 0.6 to 1.2 milligrams (mg) per deciliters (dl) in adult males and,
  • 0.5 to 1.1 milligrams (mg) per deciliter (dl) in adult females.

 

2.  Blood Urea Nitrogen (BUN)

 

Significance of BUN

 

  • The liver produces ammonia (which contains nitrogen ) as a byproduct of protein metabolism.
  • The nitrogen combines with elements such as hydrogen, carbon, and oxygen to form urea. This is also called urea nitrogen.
  • Urea nitrogen is transported to the kidney from the liver by the bloodstream.
  • Healthy kidneys remove urea nitrogen and other waste products from the blood through urine.

 

What is the normal value of BUN?

 

The normal value of BUN is 7 to 20 mg/dL or 2.5 to 7.1 mmol/L.

 

 

3. Estimated Glomerular Filtration Rate (eGFR)

 

What is eGFR?

  • GFR is the short form of Glomerular Filtration Rate.
  • It is the amount of blood that is filtered by the glomeruli per minute.

 

How Estimated Glomerular Filtration Rate (eGFR) is calculated?

 

From the different equations, the two most commonly used equations to calculate eGFR  are as follows :

 

  • Equation 1: Chronic Kidney Disease  Epidemiology Collaboration (CKD-EPI) creatinine equation.
  • Equation 2: Modification of Diet in Renal Disease Study (MDRD) equation
  • Data required are a person’s blood creatinine level, cystatin C result, age, and assigned value based upon sex and race.

 

Interpretation of eGFR result

 

Kidney Damage Stage             

 

 

Description      Estimated GFR

 

1 Normal or minimal damage with normal GFR 90+
2 Mild decrease in GFR 60-89

 

3 Moderate decrease in GFR 30-59

 

4 Severe decreased in GFR 15-29

 

5 Kidney failure <15

 

 

4. Cystatin C concentration

 

  • Cystatin C is a protein that is produced by cells in the body.
  • If the level of cystatin C is too high in the blood than it may indicate that the kidneys are not working properly.
  • It is also used in combination with serum creatinine for the calculation of eGFR.
  • Serum Cystatin C is not affected by gender, age, race, and muscle mass.

 

The normal level of serum cystatin C

 

The normal level of serum cystatin C ranges from 0.6 to 1 mg/L.

 

What urine test detects kidney function?

 

1.  24-hour urine creatinine clearance test

 

Significance of 24-hour urine creatinine clearance test

 

  • A creatinine urine test measures the amount of creatine in the urine.
  • It is more accurate to collect the urine for a whole day to get the value of creatinine, rather than one sample of urine.
  • The creatinine in urine can vary a  lot based on diet, exercise, and hydration levels so, a single reading is not helpful.

 

The normal value of creatinine test

  • 14 to 26 mg per kg of body mass per day for men.
  • 11 to 20 mg per kg of body mass per day for women.

 

2. ACR (Albumin to Creatinine Ratio)

 

  • Normal individuals excrete a very small amount of protein in the urine. Albumin is the most common type of protein in the urine.
  • Albuminuria is increased excretion of urinary albumin and it is a sign of kidney damage.

 

How ACR is calculated?

 

The doctor calculates it by dividing albumin concentration in micrograms by creatinine concentration in milligrams from a urine sample.

 

The normal value of ACR

 

ACR (microgram/mg)

 

Significance
Less than 30 Normal to mildly increased

 

30-300 Moderately increased

 

More than 300 Severely increased

 

 

 

 

Frequently Asked Questions (FAQs)

 

Can a blood test detect kidney problems?

Blood tests that show kidney function tests are Serum Creatinine Test, Blood Urea Nitrogen (BUN), Estimated Glomerular Filtration Rate (eGFR, and Cystatin C concentration.

What is normal creatinine?

The normal values of serum creatinine are 0.6 to 1.2 milligrams (mg) per deciliters (dl) in adult males and, 0.5 to 1.1 milligrams (mg) per deciliter (dl) in adult females.
The normal urine creatinine is 14 to 26 mg per kg of body mass per day for men and
11 to 20 mg per kg of body mass per day for women.

Is kidney function tested in CBC?

The kidney function tests include: Serum creatinine, Blood Urea Nitrogen (BUN), Estimated Glomerular Filtration Rate (eGFR), 24-hour urine creatinine clearance test, ACR (Albumin to Creatinine Ratio), and Cystatin C

Why kidney function test is done?

Symptoms of kidney diseases may not be observed until as much as 30-40% of the kidney is damaged.
Early detection of kidney dysfunction can help to minimize future damage.
To diagnose the health status of kidney
To diagnose renal diseases and to diagnose kidney failure.
It checks dehydration status.

 

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Advantages of school health services

How malaria is diagnoses?

Can a blood test detect colon cancer?

What blood test shows anemia?

 

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Anemia testing

What blood test shows anemia?

 

 

The blood test that shows anemia is Complete Blood Counts.The first test that your doctor order is a Complete Blood Count (CBCs) that determines the level of hemoglobin, hematocrit, and RBCs that would suggest anemia.

 

 

What is anemia and what blood test shows anemia?

 

 

What blood test shows anemia?

 

Anemia is a condition in which there is not enough red blood cell in the body resulting in the deficient of the oxygen in the body.

 

It is a condition that develops when your body lacks enough healthy red blood cells or hemoglobin. Anemia occurs when we have decrease levels of hemoglobin in RBC. One billion people globally affected by the anemia.

 

Measuring hemoglobin

 

It is measured in gm per 100 ml of blood.

It is not possible to say exactly what the normal level of hemoglobin is, because it varies from person to person. We may say, however, that hemoglobin below a certain level means anemia.

Hemoglobin below these levels means anemia :

 

Group Hemoglobin level (gm/100 ml)
Children (6 months-5 years) 11
Children (6 months- 14 years) 12
Men 13
Women 12
Women (pregnant) 14

 

Degree of anemia:

 

Mild anemia: Mild anemia occurs when the hemoglobin level is 10-12 gm/dl

Moderate anemia: Moderate anemia occurs when the hemoglobin level is 7-10 gm/dl.

Severe anemia:  Severe anemia is the anemia when the hemoglobin level is less than 7 gm/dl.

 

What are the symptoms and features of anemia?

 

Symptoms of anemia are mild at first which is not recognized without the blood test.

Symptoms :

  • Fatigue
  • Breathless on exertion
  • Palpitation
  • Headache
  • Dizziness

Features of anemia

  • The pallor of skin and conjunctiva.
  • Young children with severe anemia are vulnerable to infections if they have a poor immune response.
  • Slower in physical and mental development.

Some other symptoms are:

  •   Angina
  •   Constipation and poor appetite
  •   Sleepiness
  •   Tinnitus
  •   Mouth ulcer
  •   palpitation
  •   Hair loss
  •   Fainting and feeling faint
  •   Depression
  •   Breathlessness on excretion
  •   Twitching muscle
  •   Tingling,  numbness, and burning sensation
  •   Missed and heavy menstrual cycle
  •   Slow social development etc.

Causes of anemia :

 

  • Inadequate iron intake (iron –deficiency anemia)
  • Eating the low amount of iron. i.e. less consumption of food such as meat, egg, some green leafy vegetables which are high in iron.
  • Inability to absorption.
  • Pregnancy or blood loss due to menstruation: Caused due to heavy menstrual bleeding and blood loss during delivery.
  • Internal bleeding: Certain medical conditions may cause internal bleeding e.g.; ulcer polyps in the colon, colon cancer, regular use of pain relievers. Because of this blood loss continuously and anemia may occur. 60% of adults have iron deficiency anemia due to chronic blood loss from a gastrointestinal disorder.
  • Parasitic worm infestation: In a developing country the most common cause of anemia is worm infestation. eg; hookworm, roundworm, whipworm, etc…
  • Diversion of iron of fetal erythropoiesis during pregnancy.
  • Intravascular hemolysis.
  • Hemoglobinuria and occult blood.

Risk factors of anemia :

  • Poor socio-economic condition
  • Pregnancy and lactation
  • Adolescents girls
  • Multiparity
  • Menstrual problem.

 

Types of anemia

 

According to the size of the red blood cells (7-8 μm), there are three main types of anemia :

 

1)  Microcytic anemia:

  • If the red blood cells are smaller than normal than it is called microcytic anemia.
  • The major types of anemia include iron-deficiency anemia and thalassemia.

2) Normocytic anemia:

  • If the red blood cells are normal in size (but less in amount ) then it is called normocytic anemia.
  • That includes chronic diseases or anemia related to kidney disease.

3)   Macrocytic anemia :

  • The red blood cells are larger than normal than it is called macrocytic anemia.
  • It includes pernicious anemia and folate deficiency anemia.

 

Lab diagnosis of anemia (What blood test shows anemia)

 

The first test that your doctor order is a Complete Blood Count (CBCs) that determines the level of hemoglobin, hematocrit, and RBCs that would suggest anemia.

 

 Blood test shows anemia

 

1) Complete Blood Count (CBC):

  • A complete Blood Count(CBC) is typically the first test ordered and it determines the severity of anemia.
  • Hemoglobin, Hematocrit, RBC, and RBC indices are important to know about the types of anemia.

 

2)  Peripheral blood smear:

  • Looking for red blood cells under the microscope to determine the shape, size, and appearance.

 

3)  Fecal occult blood test:

  • A test for blood in the stool may detect bleeding from the stomach or the intestine.

Other blood tests that show anemia

 

4)  Iron-level:

  • A serum iron level will help to determine whether the anemia is related to iron deficiency anemia.
  • Ferritin and transferrin level is also helpful to diagnose iron-deficiency anemia.

 

5) Vitamin B-12 level : 

  • Vitamin B-12 is for the diagnosis of pernicious anemia.

 

6) Folate level :

  • Vitamin needs to produce RBCs helpful to diagnose folate deficiency anemia.

 

7)  Bilirubin:

  • Used to determine if the RBCs are being destroyed within the body may be the sign of hemolytic anemia.

 

8)  Lead level:

  • Lead toxicity is formerly one of the more common causes of anemia in children.

 

9)  Hb- electrophoresis:

  • Helpful for diagnosis of thalassemia and sickle cell anemia.

 

10) Reticulocyte count:

  • It measures the new RBC produced by the bone marrow.

 

11) Live Function Test(LFTs):

  • A common test to determine how the liver is working which may give a clue to other underlying diseases causing anemia.

 

12) Renal Function Test (RFTs):

  • A test that can help whether any kidney dysfunction exists.
  • Kidney failure may result in erythropoietin deficiency that leads to anemia.

 

13) Bone marrow biopsy:

  • Determines the production of RBCs and may be done when a bone marrow problem is suspected.

 

Treatment of anemia :

  • Blood transfusion.
  • Using the deficient materials that are necessary for the formation of Red Blood Cells.
  • Treatment of the pathological conditions that are causing anemia.
  • Supplementary therapy.

Prevention of anemia

  • To reduce the deficiency of iron consume dark green leafy vegetables, meat, pulses, double fortified salt, wheat flour, and rice.
  • Eat sources of Vitamin-C like fruits, lemons, oranges, and guava to improve the absorption of iron in the body.
  • Avoid consuming tea or coffee along with or immediately after meals as it impairs iron absorption.
  • Consult a doctor or nutritionist for special dietary advice.

 

Frequently Asked Questions (FAQs)

What level of anemia is severe?

Severe anemia:  Severe anemia is the anemia when the hemoglobin level is less than 7 gm/dl.

How do I know if I have anemia?

Symptoms of anemia are mild at first which is not recognized without the blood test.

Symptoms :
Fatigue
Breathless on exertion
Palpitation
Headache
Dizziness
Features of anemia
The pallor of skin and conjunctiva.
Young children with severe anemia are vulnerable to infections if they have a poor immune response.
Slower in physical and mental development.

Some other symptoms are:

Angina
Constipation and poor appetite
Sleepiness
Tinnitus
Mouth ulcer
palpitation
Hair loss
Fainting and feeling faint
Depression
Breathlessness on excretion
Twitching muscle
Tingling, numbness, and burning sensation
Missed and heavy menstrual cycle
Slow social development etc.

What foods should you avoid if you have anemia?

Avoid consuming tea or coffee along with or immediately after meals as it impairs iron absorption.

What should an anemic person eat?

To reduce the deficiency of iron consume dark green leafy vegetables, meat, pulses, double fortified salt, wheat flour, and rice.
Eat sources of Vitamin-C like fruits, lemons, oranges, and guava to improve the absorption of iron in the body.
Avoid consuming tea or coffee along with or immediately after meals as it impairs iron absorption.
Consult a doctor or nutritionist for special dietary advice.

 

Also, Read :

How many kidney stones can you have?

What’s a tuberculosis test?

Can scabies make you sick?

Advantages and disadvantages of methods and media of health education

 

Also, like our official Facebook page by clicking here.

 

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testing

Can blood test detect colon cancer?

A blood test cannot detect colon cancer.

A blood test measures the chemicals. Our liver makes such chemicals or we can also find such chemicals in our liver. The level of this chemical indicates that cancer has or hasn’t spread to other parts of the body.

It checks the red blood cell counts. The lower red blood cell counts indicate that there is a presence of anemia

A blood test only finds whether the blood is present in the stool or not.

What is colorectal cancer?

 

Can blood test detect colon cancer?

 

 

Colorectal cancer is the cancer of the rectum and the colon. The other short name for colorectal cancer is colon cancer.

It is the second leading cause of death due to cancer in the United States.

Colon affects the men and women of all ethnic and racial groups.

It mainly affects people aged 50 years and more than that.

 

What are the risk factors of colon cancer?

 

The risk factors of colon cancer are:

  • People aged 50 years and more than that.
  • Genetics
  • Family history
  • Inflammatory bowel diseases
  • Lack of regular physical exercise
  • Inappropriate dietary pattern
  • Alcohol consumption
  • Tobacco use
  • Overweight
  • Obesity
  • The diet is rich in red meat or processed meat.
  • Irradiation
  • Diet poor in fiber.

 

Symptoms of colon cancer

The symptoms of the colorectal cancers are as follows :

  • Abdominal pain
  • Stomach aches
  • Stomach cramps
  • Blood in urine
  • bowel movements changes such as diarrhea
  • Loss of the weight and without any known reason
  • Persistent nausea or vomiting
  • Iron deficiency anemia.

 

Can a blood test detect colon cancer?

 

A. General test

 

The general is for the assessment of the overall health status and to detect bodily function. It includes:

i. Physical examination

ii. Blood test:

A blood test in colon cancer is for the assessment of the general health status of the person and to look after the signs that suggest to us that there is the presence of the blood in the stool.

 

Blood test measures :

  • The chemicals that are made by our liver or the chemicals that are found in our liver.
  • And checks the red blood cell counts. The lower red blood cell counts indicate that there is a presence of anemia which is common in people with colon cancer, but anemia may be also caused due to other conditions.

 

Immunochemical fecal occult blood test (iFOBT)

 

  • This test depends on the symptoms of the people.
  • It is recommended for people with weight loss, anemia, changes in the bowel movement, and abdominal pain.
  • But, it is not recommended for people who are bleeding from the rectum.
  • In this test, the doctor asks to take a sample of the stool at home and he examines the sample of stool under the microscope for microscopic traces of the blood.
  • Which indicates the sign of bowel cancer, polyps, or other bowel conditions.

The immunochemical fecal occult blood test (iFOBT) does not detect colon cancer. It only finds whether the blood is present in the stool or not.

  • If there is a presence of the blood in the stool then the doctors recommend having a colonoscopy as soon as possible of the result.
  • The colonoscopy should be done within 120 hours of the results of the iFOBT (i.e. there is the presence of blood in the stool )

 

B. Tests that find the presence of the colon cancer

 

i. Colonoscopy and bioscopy

ii. CT colonography

iii. Flexible sigmoidoscopy

C. Tests that detect the spread of cancer from the colon to other parts of the body

i.  CT scan

ii. CEA blood test :

  • CEA blood test detects the levels of the protein which is called Carcinoembryonic Antigen (CEA).
  • Some of the cancer cells produce this protein.
  • The high level of the CEA indicates that the spread of cancer from the colon to other parts of the body.
  • But the high level of the CEA in our body may be due to other medical conditions or other factors such as pregnancy or smoking.
  • This CEA blood test is used for the people who are already receiving treatment to monitor the status of colorectal cancer.

 

Frequently Asked Questions (FAQs)

 

What are the early warning signs of colorectal cancer ?

The early warning signs of colorectal cancer are Abdominal pain, Stomach aches, Stomach cramps, Blood in urine, bowel movements changes such as diarrhea, Loss of the weight without any known reason, Persistent nausea or vomiting, Iron deficiency anemia.

Does colon cancer affect blood cell count?

 

A blood test checks the red blood cell counts. The lower red blood cell counts indicate that there is a presence of anemia which is common in people with colon cancer, but anemia may be also caused due to other conditions.

 

What tests are done for bowel cancer?

Immunochemical fecal occult blood test (iFOBT), Colonoscopy and bioscopy, CT colonography, CT scan, CEA blood test, and Flexible sigmoidoscopy

What is the main cause of bowel cancer?

The risk factors of colon cancer are People aged 50 years and more than that, Genetics, Family history, Inflammatory bowel diseases, Lack of regular physical exercise, Inappropriate dietary pattern, Alcohol consumption, Tobacco use, Overweight, Obesity, The diet is rich in red meat or processed meat, Irradiation, Diet poor in fiber.

 

 

Also read:

Can scabies make you sick?

Advantages of school health services

how malaria is diagnoses?

 

Also, check us on our official Facebook page

 

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testing

How Often Should Health-Care Workers Be Tested For TB?

Introduction to health care workers tb test

Health-care Workers fall under high risk group to Tuberculosis (TB), due to their occupational exposure to infectious diseases. So it becomes essential to conduct testing of Health-Care Workers for TB infection.

The CDC (Centers for Disease Control and Prevention) and NTCA (National Tuberculosis Controllers Association) have created updated guidelines regarding TB screening and testing in Healthcare setups in 2019. These guidelines provide structural framework for the screening, testing, frequency of testing and preventive treatment for health care workers.

 

How Often And When Should The Health-Care Workers  Be Tested?

The updated guidelines made the following changes in terms of screening and testing:

  • Decrease in frequency of TB screening for the Health-Care Workers in various settings. Change in criteria of screening frequency changed.
  • Clear testing criteria of the health care professionals.

Guidelines for the frequency of testing and criteria of the testing of TB in Healthcare setting:

  • Baseline testing of health professional required. Annual additional tests are not performed if the exposure to the infection is null.
  • Interferon Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) with confirmed exposure to TB and who have no prior documented TB infection or Latent TB Infection (LTBI),
  • In personnel with newly positive test result, symptom evaluation and chest radiography with followup as indicated,
  •  Unless contraindicated, personnel with untreated Latent TB Infection encouraged to undergo treatment,
  • Annual symptom based screening for individuals with untreated LTBI,
  • The health professionals are provided with annual education on TB.

 

What Is TB Risk Assessment And How It Affects TB Screening Process In Health- Care Setups?

Risk Assessment is evaluation process to see the risk of transmission of Mycobacterum tuberculosis in a setting. The testing should be done even when there is no recent exposure to TB. Risk assessment is essential to check the status of a health setup and proper occupational health measures.

Risk Assessment helps in effective prevention of the spread. It checks the need of improvement in the strategies to adopt Administrative, Environmental and Respiratory Protection Control required for a health care settings.

TB Screening According To Risk Assessment:

Risk Assessment classifies screening into three groups:

  1. Low Risk Setup : Conduct a baseline screening test when hiring the individual. In such setup, annual screening is not necessary.
  • Medium Risk Setup : Conduct a baseline screening test when hiring the health professional . After baseline screening, the individuals need to be assessed annually by symptom screening or test for M. tuberculosis. Individuals with a baseline positive M. tuberculosis infection should receive one chest radiograph result to exclude TB disease.
  • Screening for Health-Care Workers or settings classified as Potential Ongoing Transmission: Testing is performed in a gap of 8 to 10 weeks until the infection transmission seems to be under control and there is no apparent ongoing transmission in the setting.

 

The Potential Ongoing Transmission stage should be treated with urgency and prompt investigation and preventive measures should be taken. It is used as a secondary classification. Even when the disease is under control and no apparent transmission is seen, the hospital setting should be treated as Medium Risk for one year.

In classification of Low and Medium Risk settings, the setting is classified and treated as Medium Risk setup.

 

The Essentials of TB Infection Control:

Any health care setting needs a prompt plan of action to control the spread of TB infection through detection, precautions and treatment facilities. The control program is summarized into three categories:

  1. Administrative controls:  It includes management to reduce risk of exposure to TB infected people. Administrative control measures include :conduction of a TB risk assessment of a setting, educating the health care workers on aspects like prevention and treatment of TB infection, use of epidemiological study methods for prevention, screening and testing of health care workers who are at a risk of infection, effective work practices for the management of patients.
  2. Environmental controls: The transmission of TB infection is usually through droplets of the infected person. In order to prevent transmission, reduction of infectious droplet is important. The use of general ventilation and HEPA ( High Efficiency Particulate Air) helps decrease the contaminated droplet concentration in air.
  3. Respiratory-Protection controls: The Administrative and Environmental approach deal with minimizing the exposure of the patient to the infection. Respiratory Protection control is used in situations of high exposure areas, like in Health care workers. In this control, training Health care workers on respiratory protection is done and respiratory hygiene is taught.

 

Reference : https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm?s_cid=rr5417a1_e