Evaluation of a tuberculosis screening and prophylaxis program for international students

In many parts of the world, tuberculosis (TB) is still a major cause of morbidity and mortality. Because of the high rate of worldwide TB infection, the University of California, Los Angeles (UCLA), requires nonimmigrant foreign students to have a tuberculin skin test before completing registration for classes. Out of 589 students tested, 57.6% were positive (n = 339) at the level of 5 mm induration or greater. All positive reactors with no contraindications to isoniazid (INH) were urged to take INH chemoprophylaxis (n = 290). Several strategies designed to improve compliance were used with all students. In addition, some students attended a lecture and discussion prior to initiation of therapy. Completion rates were low for all students, including those who attended the lecture-discussion session. Implications of the results for future screening activities are discussed.