From: Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis
Strategy | Pre-travel tuberculin skin test results | Interpretation of pre-travel results | Intervention | |
---|---|---|---|---|
 | Test 1 | Test 2 |  |  |
Pre-trip two step tuberculin test Treat converters | ≥ 10 mm | N/A | Baseline latent tuberculosis infection (LTBI) | No intervention. Passive diagnosis of TB disease pursued if symptomatic post-travel. |
 | <10 mm | ≥ 10 mm | Booster effect; no baseline LTBI | No intervention. Passive diagnosis of TB disease pursued if symptomatic post-travel. |
 | <10 mm | <10 mm | No LTBI | Post-trip tuberculin test. Converters prescribed isoniazid. |
Pre-trip two step tuberculin test Treat reactors and converters | ≥ 10 mm | N/A | Baseline LTBI | Prescribe isoniazid. |
 | <10 mm | ≥ 10 mm | Booster effect | No intervention. Passive diagnosis of TB disease pursued if symptomatic post-travel |
 | <10 mm | <10 mm | No LTBI | Post-trip tuberculin test. Converters prescribed isoniazid |
Post-trip tuberculin test | None |  | None | One post-trip tuberculin skin test. All reactors (≥ 10 mm) prescribed isoniazid. |
Post-trip chest x-ray | None |  | None | Chest x-ray post-trip. Persons with radiographic abnormalities compatible with TB, negative workup for active TB, and TST ≥ 5 mm prescribed isoniazid. |
No screening | No intervention before or after trip. Passive diagnosis of TB disease pursued if symptomatic post-travel. |