Worldwide, tuberculosis (TB) remains one of the most common causes of infectious morbidity and mortality, worsening with the COVID 19 pandemic.
Although TB is well controlled in WA, new cases are diagnosed every week and in 2023 there was a surge in notifications following the opening of international borders.
WA Department of Health reminds GPs to be alert to the possibility of TB because it often has an indolent presentation of non-specific symptoms that can be easily overlooked. TB should be considered in any patient with:
- Prolonged cough (more than three weeks).
- Unexplained fever that is unresponsive to routine antibiotics
- Unexplained weight loss.
- Lymphadenopathy, especially of the neck.
The diagnosis should be considered in migrants from countries where TB is common (Asia, Africa, Pacific Islands, South America, Eastern Europe) and Aboriginal Australians.
The key to diagnosis is to collect relevant samples for TB culture (sputum, urine, fine needle aspirate etc.). A chest x-ray is a good screening test for pulmonary TB that will usually rule out TB if normal, but it does not make the diagnosis. A CT of the chest is rarely needed. QuantiFERON blood test diagnoses latent TB infection but neither proves nor excludes active TB.
The WA Tuberculosis Control Program based at the Anita Clayton Centre in Perth provides a state-wide outpatient public health service and expert advice on matters related to TB. The program offers a comprehensive service that includes treatment advice and provision of medications (free of charge). All clients on TB treatment are assigned a nursing case manager who supports them during their TB treatment.
For advice for clinicians on assessment, management, and referral of patients with suspected TB, see HealthPathways WA Tuberculosis.
For more information contact the WA Tuberculosis Control Program via 9222 8500 (Monday – Friday, 8.30 – 4.30) or email ACCadmin@health.wa.gov.au.