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All outpatient referrals to the TB service are reviewed by the TB consultant and/or a specialist TB nurse within 24 hours of receipt. In addition to a weekly TB clinic, there is also a Rapid Access nurse-led clinic, Mantoux clinic and a therapy monitoring service.
In addition to conventional chest imaging, blood tests, Mantoux skin test, sputum induction and bronchoscopy, an in-house interferon-gamma release assay (IGRA) based the Elispot® technology has been available since 2007 to enhance the diagnosis of latent TB infection.
Healthcare worker screening and exclusion of latent TB infection in potential recipients of systemic anti-biological therapy (e.g. anti-TNF-alpha agents) are important aspects of the TB service.
All patients on prophylaxis or full treatment are closely monitored for compliance and the emergence of potential side effects, including by DOT (Directly Observed Therapy) if necessary.