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Return of tuberculosis: screening and preventive therapy.

P T Dowling1

  • 1L.A. County-Harbor/UCLA Medical Center, Torrance.

American Family Physician
|February 1, 1991
PubMed
Summary

Screening for Mycobacterium tuberculosis infection using the tuberculin skin test is crucial, especially for high-risk groups. Early isoniazid therapy significantly reduces the risk of developing active tuberculosis disease.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Medical Screening

Background:

  • Approximately 25% of individuals exposed to Mycobacterium tuberculosis (TB) become infected.
  • About 10% of infected individuals develop clinically active TB during their lifetime.
  • TB screening is vital, particularly for vulnerable populations.

Purpose of the Study:

  • To highlight the importance of tuberculin skin testing for TB screening.
  • To identify high-risk groups for tuberculosis infection.
  • To emphasize the role of isoniazid therapy in preventing active disease.

Main Methods:

  • Utilizing the tuberculin skin test (TST) for screening.
  • Assessing induration size (5-15 mm or more) to indicate infection.
  • Administering isoniazid therapy to positive TST reactors.

Main Results:

  • TST is recommended for all patients, especially the young, elderly, and immunocompromised.
  • Positive TST reactions, with induration between 5-15 mm, generally indicate infection.
  • Isoniazid therapy reduces TB disease risk by 60-80% in positive reactors.

Conclusions:

  • Family physicians are critical in TB elimination efforts.
  • Early detection and treatment of latent TB infection are key to preventing active disease.
  • Targeted screening and preventive therapy can significantly impact TB rates.

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