The
provisional CDC guidelines say
Populations/situations in which IGRAs are preferred
– testing persons from groups that historically have poor rates of return for TST reading
Which populations might that be? Bothamley et al, from the East London Tuberculosis Service, looked at their
data of screening new entrants in a hospital based new entrants' clinic, general practice and centres for the homeless and found that
Attendance for screening was 17% of the port of arrival notifications (63% had registered with a GP), 54% in primary care, and 67% in the homeless (42% registered with a GP)
On the other side of the pond
Dewan et al, from both the the CDC and California, found that the return rate to be 79% and noted
the reported return rate for TST reading in similar patient populations in other cities, including 84% at a needle-exchange program in Baltimore, 64% at a public health program in Atlanta, and 47% in a street outreach program for drug users in Long Beach
So it seems that for migrants, general practice, homeless, public health and drug users the rates of return are
historically poor and the CDC would
prefer IGRA to
all these groups.
