JPETS Technical Instruction

TRUE or FALSE.  An applicant below age 5 with signs and symptoms suggestive of active TB should proceed with Chest X-ray examination instead of TST/IGRA.

• True

• False

Answer explanation

TRUE.

* TST/IGRA - Do this next when History/PE is NOT suggestive of active TB

* Chest X-ray - If History/PE is suggestive of active TB, children under 5 year old must undergo CXR. If CXR is not suggestive of active TB, then TB Certificate can be issued. 

* Sputum test - This will only be done for applicants below age 5 (with signs and symptoms of active TB) whose CXR result is suggestive of active TB

Which of the following applicant group should have an additional lateral view, apart from the standard postero-antero (PA) CXR view?

• Below age 5

• From age 5 up to below age 15

• Both A & B

• Pregnant

Answer explanation

C -- Applicants below aged 15 years (option A & B) should receive a lateral view in addition to the standard PA view. Adults 15 years and above can have the standard PA view only. Pregnant applicants can have double shielding apart from the PA view should these applicants decide to continue with CXR

When should IGRA test be repeated?

• When the first IGRA result is negative

• When the first IGRA result is positive

• When the first IGRA result is indeterminate/invalid/borderline

• B or C

• All of the above

Answer explanation

C --

If the IGRA results are indeterminate/invalid/borderline, the Panel Physician should repeat the examination preferably using a different test from that used at the initial test (e.g. IGRA 1 = Quantiferon, IGRA 2 = 2 Quantiferon). If the result of the second test is indeterminate/invalid again, CXR must be performed. 

Which of the following formula can be used to calculate the TB certificate expiry date?

• Expiry date = CXR date + 180 days if CXR was done and applicant is not a TB contact

• Expiry date = PE date + 180 days if CXR was not done and applicant is not a TB contact

• Expiry date = IGRA date + 180 days if CXR was not done and applicant is not a TB contact

• All of the above

• A and B only

TRUE or FALSE. A TB certificate can be issued to a pregnant applicant who did not undergo CXR as long as her sputum test is negative and her pregnancy is within the first trimester.

• True

• False

Answer explanation

False --

CXR is mandatory for all applicants 5 years old and above, regardless of pregnancy status.