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Tuberculosis

Answer

The Department has been developing a toolkit to help the national health service to implement the key points of the chief medical officer’s tuberculosis (TB) action plan through effective commissioning and delivery of services. The toolkit will recommend that TB services should always follow the NICE clinical guidelines when treating patients including those with HIV or those who are otherwise immunocompromised. The National Institute for Health and Clinical Excellence (NICE) guidelines contain clear recommendations on the appropriate use of Mantoux tests and interferon gamma tests. Economic modelling was undertaken with various strategies from no action to a two-step strategy with either tuberculin skin tests (TST, which cover both Heaf and Mantoux tests) followed by interferon gamma testing, or serial interferon gamma tests. Of these options, the model provided most support, on grounds of cost-effectiveness, for a two-step approach with an initial TST, followed by an interferon gamma test to confirm positivity. The guideline development group members also supported this because of clinical utility and feasibility.Based on this, the Health Protection Agency is developing more detailed practical guidance about the use of gamma interferon tests. It is expected that this guidance will be available to the NHS before the end of 2006.The NICE guideline was published in February 2006 and it is too early to assess how widely its recommendations are being implemented. NICE plans to evaluate its implementation tools, including that for TB, shortly.

Secondary information

Type

Written question

Reference

92412; 450 c852-3W;450 c858W

Session

2005-06

Subjects

Tuberculosis

Link

View this Written question on www.publications.parliament.uk