Diefenback-Elstob et al review risk factors for tuberculosis in a traveller. The authors are from multiple institutions in Canada.
Patient selection: traveller
Risk factors for tuberculosis:
(1) level of tuberculosis in the countries being visited (low, intermediate, high)
(2) role as traveler (with healthcare worker at greatest risk)
(3) individual risk behaviors during travels, such as residing with a household with active tuberculosis
(4) personal susceptibility factors to infection
High incidence countries (> 100 tuberculosis cases per 100,000 people):
(1) sub-Saharan Africa
(2) South or East Asia
(3) Pacific region
The authors did not find that the duration of the travels was a risk factor while other studies have.
If the person is expected to have significant risk of exposure to tuberculosis, then:
(1) consider ordering baseline tests of tuberculosis status prior to the trip. This can be important in people who are returning to visit family and friends or for those with previous exposures.
(2) instruct in ways to recognize and mitigate exposure situations, such as use of personal protective equipment (PPE)
