Related Experiment Video
Updated: May 5, 2026
A Suction Blister Protocol to Study Human T-cell Recall Responses In Vivo
Published on: August 11, 2018
Evaluation of a risk assessment questionnaire used to target tuberculin skin testing in children
P O Ozuah1, T P Ozuah, R E Stein
1Children's Hospital at Montefiore, 3544 Jerome Ave, Bronx, NY 10467. pozuah@poi.net
Insights
The New York City Department of Health (NYCDOH) tuberculosis risk assessment questionnaire effectively identifies children needing a tuberculin skin test. This targeted screening improves efficiency and accuracy in pediatric tuberculosis detection.
Area of Science:
- Pediatric Public Health
- Infectious Disease Epidemiology
- Diagnostic Test Evaluation
Background:
- Universal tuberculin skin testing in children is often inefficient and costly.
- Targeted screening based on epidemiological risk is recommended by health authorities.
- The New York City Department of Health (NYCDOH) developed a risk assessment questionnaire to identify children requiring testing.
Purpose of the Study:
- To evaluate the sensitivity, specificity, and predictive validity of the NYCDOH tuberculosis risk assessment questionnaire.
- To determine the effectiveness of targeted screening for pediatric tuberculosis.
Main Methods:
- A prospective criterion standard study was conducted involving 2920 children aged 1-18 years.
- Tuberculin skin tests and the NYCDOH questionnaire were administered simultaneously.
- Key questions focused on tuberculosis case contact, endemic area travel/birth, high-risk adult contact, and HIV status.
Main Results:
- The NYCDOH questionnaire identified 14% of children with at least one risk factor.
- A positive skin test occurred in 5.6% of children with risk factors versus 0.16% without.
- The questionnaire demonstrated 85.2% sensitivity, 86.0% specificity, and a 99.8% negative predictive value.
Conclusions:
- The NYCDOH questionnaire is a validated tool for identifying children who require tuberculin skin testing.
- Targeted screening using this questionnaire enhances the efficiency of pediatric tuberculosis detection.
Context:
Universal tuberculin skin testing of children has been shown to be costly and inefficient. In response, several authorities have recommended targeted screening based on epidemiological risk. In 1996, the New York City Department of Health (NYCDOH) developed questions to identify children who require a tuberculin skin test.
Objective:
To determine the sensitivity, specificity, and predictive validity of the NYCDOH tuberculosis risk assessment questionnaire.
Design:
Prospective criterion standard study in which tuberculin skin tests and the NYCDOH questionnaire were administered simultaneously between August 1996 and January 1998. Specific questions asked about contact with a tuberculosis case, birth in or travel to endemic areas, regular contact with high-risk adults, and human immunodeficiency virus infection in the child.
Setting:
Ambulatory clinic in South Bronx, New York, NY.
Participants:
Consecutive sample of 2920 children aged 1 to 18 years.
Main Outcome Measures:
Sensitivity, specificity, positive and negative predictive values of the questionnaire, and odds ratio (OR) of reactive skin test results.
Results:
The NYCDOH questionnaire identified 413 children (14%) as having at least 1 risk factor. Of these, 23 (5.6%) had a positive skin test result; 4 (0.16%) of the 2507 without risk factors had a positive result. Results for the full NYCDOH questionnaire were sensitivity, 85.2%; specificity, 86.0%; negative predictive value, 99.8%; positive predictive value, 5.4%; and OR, 35.2 (95% confidence interval, 12.1-102.4).
Conclusion:
The NYCDOH questionnaire is a valid instrument for identifying children for tuberculin skin testing.
More Related Videos
06:26Author Spotlight: Optimizing CFU Determination for Efficient Assessment of TB Vaccine Efficacy and Antigen Presentation Analysis
Published on: July 28, 2023
02:28Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
Published on: March 1, 2024
Related Concept Videos
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...