1. Algorithm for TB Testing in Children
TB Risk Questionnaire positive?
Screening Complete No
Yes
TST
Preferred*
Age < 5 years?
Yes No
Likely to return for TST reading?
TST or IGRA Acceptable
BCG Vaccinated? No
Yes
Yes No
Initial TST Done? No
IGRA
Preferred
Yes
Positive
TST Result?
Negative
Yes
Concern for TB disease?*
Positive, testing complete
Negative
Indeterminate No
Repeat IGRA
Concern for TB disease?*
Negative, testing complete
Indeterminate No
Yes
Negative, testing complete
Consider TST if not done
*Either positive TST or IGRA considered significant (indicative of TB infection or disease) if there is clinical suspicion of disease or high risk for progression or poor outcome in patients with latent TB infection
Geltemeyer A, Smith KC. 16th Annual Conference of the IUATLD-North American Region, Feb 2012.