Cellular Laboratory

ELISPOT

Summary

Science

Clinical

Clinical

TB infection has always posed a significant health problem for the developing world having been brought under control in the developed world. However, due to the increased movement of populations, increasing immunodeficiencies such as HIV infection and emerging drug resistant strains of the TB microorganism, the problem is increasingly considered a global problem. This means that doctors are increasingly more likely to encounter cases in their surgeries and clinics. A doctor may consider investigating a patient for pulmonary TB (the most common form) if he/she presents with symptoms including a prolonged cough, chest pain, haemoptysis (coughing up blood), fever, chills, appetite loss, weight loss and fatigue. The patient would be referred to a specialist clinic where a blood sample would be taken for the immunology laboratory to confirm the diagnosis. Healthcare scientists in the laboratory will perform an ELISPOT test and if a positive result they will contact the TB nurse and clinician to let them know. On receiving the diagnosis the immediate concern is for the patient’s treatment and management so a course of antibiotics would be prescribed. Whereas most bacterial infections often only need a short course of treatment, active TB infection requires a longer period of multiple antibiotic therapy (from 6 to 12 months) to remove the infection completely. To ensure that the patient takes all of his/her medication, the pills are given by a doctor or nurse. This is called DOTS for “direct observation of treatment”. A secondary concern is preventing the spread of infection within the immediate population, the patient’s contacts. This is important if, for example, the patient was attending school. In this case it would be necessary to immediately remove the child from school and to screen their classmates and teachers for the infection.

• Science