TB prevention

Order no. V-837 of the Minister of Health of the Republic of Lithuania of 23 June 2016 on the approval of the description of the procedure for detection of persons with TB and case management.

People at high risk for developing TB disease include:

1. Close contacts to infectious patients with tuberculosis: family members or other persons staying in the same premises (in a room, apartment or individual house, etc.), working or studying together (hereinafter referred to as close contacts);
2. Persons infected with human immunodeficiency virus (HIV);
3. Persons addicted to alcohol, drugs and other substances;
4. Persons in detention places;
5. Persons living in closed groups (nursing homes, shelters for the homeless, etc.);
6. Persons with medical conditions that increase the risk of contracting TB:

6.1. Persons who have been recently infected with TB bacteria, people who have latent TB infection ;
6.2. Persons with oncological diseases;
6.3. Persons who have had bowel resection;
6.4. Persons suffering from diabetes;
6.5. Persons suffering from renal insufficiency;
6.6. Persons with body mass index 10 percent lower than the norm;
6.7. Persons treated with corticosteroids and/or immunosuppressive drugs (including after bone marrow or organ transplantation);
6.8. Persons to be treated, undergoing the treatment and after the treatment (6 months after the treatment) with tumour necrosis factor inhibitors;

7. Persons arriving from countries with a high incidence of tuberculosis (more than 50 cases per 100,000 inhabitants);
8. Children belonging to a risk group, as defined by Order No. 399 of the Minister of Health of the Republic of Lithuania of 6 August 2002 on approval of tuberculin test performance and statistical report form No. 9 "Statistical report on the performance of tuberculin testing":

8.1. Not vaccinated against tuberculosis
8.2. In contact with TB infected individuals (family, group)
8.3. Children often suffering from upper respiratory tract disorders
8.4. With chronic diseases
8.5. Undergoing treatment with corticosteroids
8.6. Living with HIV or other immunodeficiency condition
8.7. Children from social risk families
8.8. Children living in centres for infants with impaired development, children's care homes, boarding schools, boarding houses
8.9. Migrants
 

Whether a person who has been in contact with someone with open TB will become infected and/or develop TB disease depends on many factors.

People at highest risk of contracting TB are: 

People living in the same household and family members, also people in closed groups (e.g. prisons, shelters for the homeless or migrants, schools, offices and those who have a long-term close contact with a TB patient).

Factors causing a risk of infection and/or disease:

• Exposure time (e.g., 8 hours or more);
• Dose of infection;
• The environment where a contact takes place (the risk is greater in small, closed rooms, rooms with poor ventilation, air recirculation);
• The condition of the patient with tb (e.g., the amount of tm released into the environment, whether the person uses drugs or not);
• The age of the person who had a contact (e.g., child under 5 or an adult);
• Health conditions of the person who had a contact (e.g., immunosuppression, diseases, etc.);
• Properties of mycobacteria (pathogenicity, virulence).
 

A person who has open tuberculosis (TB) is treated according to the recommendations for the treatment of tuberculosis (Lithuanian, World Health Organization (WHO)).

Treatment begins in a health care facility that provides in-patient services.

After initial treatment at health care facility, a person with open TB, if mycobacterium tuberculosis is no longer detected in sputum culture, can continue to be treated on an out-patient basis.

Persons with open TB, if Directly Observed Therapy (DOT) for the treatment of Tuberculosis cannot be ensured, especially those suffering from a drug-resistant form of tuberculosis, are treated in an in-patient facility for the entire course of treatment.
 

The Law on Prevention and Control of Communicable Diseases of the Republic of Lithuania and Order No. 258 of the Minister of Health of the Republic of Lithuania 06/06/2002 on approval of the order of hospitalization and/or necessary isolation of patients, persons suspected of having communicable diseases, persons who had a risky contact, and carriers of pathogens.

2-way chest x-ray should be performed for adults and a tuberculin test for children.

In health care institutions, tuberculin test should be done for children aged 6-7. For children at risk the test is performed every year.

Yes. All employees working at children's institutions are required to undergo a health check for TB before starting work and should be tested annually.