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Screening for pulmonary tuberculosis among military conscripts in Taiwan
Chen-Yuan Chiang1, Jen Suo, Ming-Chih Yu
1Chronic Disease Control Bureau, Department of Health, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|March 14, 2003
Summary
Taiwan
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Control
Background:
- Military service is mandatory for medically fit young men in Taiwan.
- Annual health checks are conducted for 19-year-old men to assess military eligibility.
Purpose of the Study:
- Determine the prevalence of pulmonary tuberculosis (TB) among military conscripts in 1997-1998.
- Evaluate the impact of mass radiographic screening on reported TB case rates.
Main Methods:
- Chest roentgenography (CXR) for all 19-year-old men during annual health checks.
- Follow-up CXR and sputum examinations for individuals with suspicious lesions.
- Analysis of TB case rates from the National TB Register (1997-1998).
Main Results:
- Pulmonary TB diagnosed in 237 (0.08%) of 305,140 conscripts.
- Low bacteriologic confirmation rate (6.9/100,000).
- Increased reported TB case rate among 19-year-old males due to screening.
Conclusions:
- Mass radiographic screening for military conscripts significantly increased reported TB cases.
- Low bacteriologic confirmation suggests potential over-diagnosis by CXR.
- Screening inefficiency for bacteriologically confirmed TB has implications for national TB programs.