Counselling for IGRA/TST

Interferon Gamma Release Assay (IGRA) and Tuberculin Skin Tests (TST) are performed on individuals who are ruled out for active TB disease. 

However, positive and negative tests in IGRA and TST do not necessarily mean the person does or does not have Tuberculosis Infection (TBI) as the possibility of false positives and false negatives cannot be ruled out in these tests.

Importance of Counselling in IGRA/ TST

• All patients who undergo IGRA/ TST are already aware that they do not have an active TB disease and hence counselling is important to help them make informed decisions about undergoing IGRA/ TST for detecting TBI.
• Additionally, at the time of receiving positive IGRA/ TST results, they may be symptom-free or otherwise healthy. In such cases, resistance/denial to receive a prophylactic treatment like TB Preventive Therapy (TPT) is higher as its treatment course duration also is relatively longer.
• Counselling in IGRA/ TST is of utmost importance when the respective person belongs to the key and vulnerable population and needs to be necessarily initiated on TPT and thus needs to be counselled for the same.

Components of Counselling in IGRA/ TST

• Information on TBI
• Need for undergoing IGRA/ TST
• Importance of initiating TPT post-IGRA/ TST tests
• If initiated on treatment, then schedule of medication
• Medication adherence support
• Follow-up
• Importance of completing the TPT course, adverse events

Resources

• Guidelines for Programmatic Management of Tuberculosis Preventive Treatment in India, CTD, MoHFW, India, 2021.
• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, CTD, MoHFW, India, 2021.

Assessment