Background. The Czech Republic belongs to low TB burden countries in last years with incidence
around 10/100,000. In such countries TB control consist in not only finding and effective treatment of
new TB cases but in identification and containment of pool for new TB cases (latent or subclinical TB
infection – LTBI) as well. Recently amended recommendations for TB control in other low TB burden
countries, US and England and Wales, were published. The objective of the paper was to determine
which of the amended recommendations could be used in our country.
Methods and Results. In England and Wales the BCG vaccination is recommended only in newborns
from families with higher TB risk. In these groups it is necessary to seek out new TB cases as well. In
TB diagnostic, emphasis is now placed in England and Wales and also in the US on the use of several
diagnostic methods. Drug use self check is more appropriate in all health responsible patients. Liquid
drug forms or fixed-dose combination tablets are recommended as well. In both above mentioned countries
the LTBI diagnostic is done either by tuberculin skin tests (TST) or by in vitro immunological IGRA
tests. In England and Wales positive TST is followed by IGRA test, in the US either TST or IGRA test
is recommended. LTBI persons are preventively treated.
Conclusions. In the Czech Republic the introduction of IGRA tests for LTBI diagnostic should have,
due to the BCG policy, even higher benefit. Introduction of IGRA tests seems to be inevitable. Persons
with supposed LTBI should be offered either preventive treatment or intensive follow up care with the
objective to detect early even incipient signs of TB. As TB develops most often soon after LTBI conception
this follow up care should last several years after LTBI detection.
tuberculosis, latent (subclinical) tuberculous infection, BCG vaccination, chemoprophylaxis,
IGRA tests, tuberculin skin test.