Such a program, initiated by the Tennessee Department of Health, prevented an estimated 184 cases of active tuberculosis during its first 5 years.
Although the overall number of new tuberculosis (TB) cases has declined in the U.S., the proportion of cases among foreign-born individuals has increased. Most such cases are due to reactivation of latent TB infection (LTBI).
To address this problem, the Tennessee Department of Health initiated a targeted tuberculin testing program in which individuals determined to have any risk factor for TB exposure (or for progression to active TB, once infected) are screened using the tuberculin skin test (TST), and those with positive test results receive treatment for LTBI. Now, researchers have evaluated the results of this program from its initiation, in March 2002, through December 2006.
After initial risk screening of 168,517 people, 125,200 individuals had a TST placed. Of these, 91,332 (73%) were considered to be high risk, including 21,680 (17%) who were foreign born. Among 102,709 recorded TST results, 9090 (9%) were positive. The positive TST rate was 33% for foreign-born persons, compared with 5% for high-risk, U.S.-born individuals and 1% for low-risk individuals. The number needed to test to identify one case of LTBI was 4 for foreign-born individuals, 24 for high-risk, U.S.-born persons, and 85 for low-risk persons. A total of 4780 individuals with positive TST results initiated LTBI therapy, and 1953 (54%) completed it. An estimated 184 cases of active TB were prevented.
Comment: These findings suggest that targeted testing and treatment of persons at high risk for TB, particularly those who are foreign born, can result in marked reductions in TB rates over time.
ARYAN'S BLOG 