Tuberculin Skin Test Screening in Schoolchildren in the United States

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 97-102 ◽  
Author(s):  
Cynthia R. Driver ◽  
Sarah E. Valway ◽  
Michael F. Cantwell ◽  
Ida M. Onorato
Keyword(s):  
United States ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Local Level ◽  
District Of Columbia ◽  
The United States ◽  
Tuberculous Infection ◽  
Foreign Born ◽  
School Based

Objective. To determine the current practices and results of tuberculin skin test (TST) screening of schoolchildren in the United States. Methods. Tuberculosis program staff in all states and the District of Columbia were asked about current requirements, practices, and results of school-based TST screening. Results. Thirty-four states and the District of Columbia (69%) reported no current statewide statutes or policies for tuberculin screening of schoolchildren, and 10 (19%) reported having statewide requirements. In 6 states (12%), requirements were instituted at the local level, and 24 localities in these states were known to require screening. Of the 34 areas requiring screening, 18 (53%) screened all new entrants, 7 (21%) screened children in specific grades, and 9 (26%) used other criteria for screening. TST results were collected for 26 (76%) of 34 areas, and 6 areas collected results of follow-up evaluation of tuberculin-positive children. Additionally, 8 localities in 7 states with no screening requirements conducted tuberculin surveys. Sixteen areas provided results. In 7 of the 8 areas that collected information about birthplace, less than 2% of US-born children were tuberculin positive; foreign-born children had rates 6 to 24 times higher than US-born children. TST screening identified few cases of tuberculosis, less than 0.02% of the children screened. Conclusion. School-based tuberculin screening identified low rates of positive TST results in US-born children. Resources should be directed toward screening children at high risk for tuberculous infection, as recommended by the American Academy of Pediatrics and the Advisory Committee for Elimination of Tuberculosis.

scholarly journals The prevalence and characteristics of adults with latent tuberculous infection in the United States and the implications for healthcare in Texas

2021 ◽  
Vol 9 (39) ◽  
pp. 53-62
Author(s):  
Shazma Khan ◽  
Crystal Ike ◽  
Jeff Dennis ◽  
Kenneth Nugent
Keyword(s):  
Skin Test ◽  
Blood Test ◽  
The United States ◽  
Active Tuberculosis ◽  
Positive Skin Test ◽  
Tuberculous Infection ◽  
Age Group ◽  
Foreign Born ◽  
Positive Skin ◽  
Department Of Health

The Centers for Disease Control and Prevention reported 8,916 cases of tuberculosis in 2019. Reducing the number of cases of active tuberculosis requires identification of patients with latent tuberculous infections (LTBI). Optimal screening for LTBI requires information about the demographics and characteristics of people who are more likely to have had tuberculous infection. Information from the 2011–2012 National Health and Nutrition Examination Survey (NHANES) was used to determine the number and characteristics of adults from a representative sample of the United States who had LTBI. Latent tuberculous infection was identified either by a positive skin test or by a positive QuantiFERON blood test. Information about the number of patients with active tuberculosis in Texas was determined from reports from the Texas State Department of Health Services. The NHANES database for the years 2011-2012 included 5,684 adults. Participants with a positive QuantiFERON blood test were more likely in the age group 45-64, male, foreign born, and have less than a high school education. Participants with a positive skin test had similar characteristics. Participants who had both a positive skin test and positive QuantiFERON test were more likely to be in the age group 45-64, males, foreign born, and Hispanic. In addition, they had diabetes, self-reported fair/poor health, and an educational level less than high school. In the State of Texas tuberculosis occurred more frequently in individuals older than 75 who were male and were not US born Texas residents. Important clinical diagnoses included diabetes, alcohol abuse, correctional facility residence, non-injection drug use, positive HIV status, and homelessness. Information from the NHANES study and from the State Department of Health Services in Texas provides information needed to develop screening programs for latent tuberculosis and active tuberculosis.

Prevalence of Tuberculin Skin Test Positivity and Conversions Among Healthcare Workers in New York City During 1994 to 2001

2003 ◽  
Vol 24 (11) ◽  
pp. 807-813 ◽  
Author(s):  
Sharlette Cook ◽  
Khin Lay Maw ◽  
Sonal S. Munsiff ◽  
Paula I. Fujiwara ◽  
Thomas R. Frieden
Keyword(s):  
United States ◽  
New York ◽  
New York City ◽  
High Risk ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
York City ◽  
The United States ◽  
Low Risk ◽  
Occupational Settings

AbstractObjective:To determine the prevalence of and risk factors for tuberculin skin test positivity and conversion among New York City Department of Health and Mental Hygiene employees.Design:Point-prevalence survey and prospective cohort analysis. Sentinel surveillance was conducted from March 1,1994, to December 31, 2001.Participants:HCWs in high-risk and low-risk settings for occupational TB exposure.Results:Baseline tuberculin positivity was 36.2% (600 of 1,658), 15.5% (143 of 922) among HCWs born in the United States, and 48.5% (182 of 375) among HCWs not born in the United States. There were 36 tuberculin conversions during 2,754 observation-years (rate, 1.3 per 100 person-years). For HCWs born in the United States, the risk for tuberculin conversion was greater in high-risk occupational settings compared with low-risk settings (OR 5.7; CI95, 1.7–19.2;P< .01). HCWs not born in the United States and those employed at the Office of the Chief Medical Examiner (OCME) were at high risk for baseline tuberculin positivity (OR, 3.2; CI95,1.7–5.8;P< .001); OCME HCWs (OR 4.7; CI95, 2.3–9.4;P< .001), those of Asian ethnicity (OR 4.3; CI95,1.4–13.5;P< .01), and older HCWs (OR, 1.0; CI95,1.0–1.1;p< .05) were at a higher risk for conversion.Conclusions:Although the prevalence of tuberculin positivity decreased after the peak of the recent TB epidemic in New York City, the conversion rate among HCWs in high-risk occupational settings for TB exposure was still greater than that among HCWs in low-risk settings. Continued surveillance of occupational TB infection is needed, especially among high-risk HCWs.

Wrestling with 9/11: Immigrant Perceptions and Perceptions of Immigrants

2006 ◽  
Vol 3 (2) ◽  
pp. 107-124 ◽  
Author(s):  
Caroline Brettell
Keyword(s):  
United States ◽  
Immigration Policy ◽  
Asian Indians ◽  
World Trade Center ◽  
The United States ◽  
Fort Worth ◽  
Foreign Born ◽  
Immigrant Populations ◽  
Trade Center ◽  
The Impact

Soon after 9/11 a research project to study new immigration into the Dallas Fort Worth metropolitan area got under way. In the questionnaire that was administered to 600 immigrants across five different immigrant populations (Asian Indians, Vietnamese, Mexicans, Salvadorans, and Nigerians) between 2003 and 2005 we decided to include a question about the impact of 9/11 on their lives. We asked: “How has the attack on the World Trade Center on September 11, 2001 affected your position as an immigrant in the United States?” This article analyzes the responses to this question, looking at similarities and differences across different immigrant populations. It also addresses the broader issue of how 9/11 has affected both immigration policy and attitudes toward the foreign-born in the United States. 

scholarly journals Natural History and Evolution of Anti-Interferon-γ Autoantibody-Associated Immunodeficiency Syndrome in Thailand and the United States

2019 ◽  
Vol 71 (1) ◽  
pp. 53-62 ◽  
Author(s):  
Gloria H Hong ◽  
Ana M Ortega-Villa ◽  
Sally Hunsberger ◽  
Ploenchan Chetchotisakd ◽  
Siriluck Anunnatsiri ◽  
...  
Keyword(s):  
United States ◽  
Natural History ◽  
The United States ◽  
Interferon Γ ◽  
Mycobacterium Abscessus ◽  
Annual Data ◽  
Persistent Infections ◽  
Ifn Γ ◽  
Immunodeficiency Syndrome

Abstract Background The natural history of anti-interferon-γ (IFN-γ) autoantibody-associated immunodeficiency syndrome is not well understood. Methods Data of 74 patients with anti-IFN-γ autoantibodies at Srinagarind Hospital, Thailand, were collected annually (median follow-up duration, 7.5 years). Annual data for 19 patients and initial data for 4 patients with anti-IFN-γ autoantibodies at the US National Institutes of Health were collected (median follow-up duration, 4.5 years). Anti-IFN-γ autoantibody levels were measured in plasma samples. Results Ninety-one percent of US patients were of Southeast Asian descent; there was a stronger female predominance (91%) in US than Thai (64%) patients. Mycobacterium abscessus (34%) and Mycobacterium avium complex (83%) were the most common nontuberculous mycobacteria in Thailand and the United States, respectively. Skin infections were more common in Thailand (P = .001), whereas bone (P &lt; .0001), lung (P = .002), and central nervous system (P = .03) infections were more common in the United States. Twenty-four percent of Thai patients died, most from infections. None of the 19 US patients with follow-up data died. Anti-IFN-γ autoantibody levels decreased over time in Thailand (P &lt; .001) and the United States (P = .017), with either cyclophosphamide (P = .01) or rituximab therapy (P = .001). Conclusions Patients with anti-IFN-γ autoantibodies in Thailand and the United States had distinct demographic and clinical features. While titers generally decreased with time, anti-IFN-γ autoantibody disease had a chronic clinical course with persistent infections and death. Close long-term surveillance for new infections is recommended.

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