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Related Experiment Videos

Tuberculosis screening in the long-term care setting.

L E Price1, W A Rutala

  • 1Department of Medicine, University of North Carolina School of Medicine, Chapel Hill 27514.

Infection Control : IC
|September 1, 1987
PubMed
Summary
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Tuberculosis (TB) skin testing in North Carolina long-term care facilities shows poor adherence to guidelines for both employees and residents. Improved TB screening practices are crucial to prevent disease spread in these vulnerable settings.

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Healthcare Policy

Background:

  • Tuberculosis (TB) poses a significant risk in long-term care facilities (LTCFs) due to vulnerable populations.
  • Adherence to established TB skin-testing protocols is essential for early detection and control of TB transmission within LTCFs.

Purpose of the Study:

  • To assess current Tuberculosis (TB) skin-testing practices among employees and residents in North Carolina long-term care facilities (LTCFs).
  • To identify areas of non-compliance with established TB skin-testing guidelines.
  • To emphasize the importance of standardized TB screening in LTCFs.

Main Methods:

  • A comprehensive TB screening questionnaire was distributed to LTCFs in North Carolina, achieving a 56% response rate.
  • Data collected included methods of TB skin testing, timing of administration and reading, interpretation of results, and use of booster tests for employees and residents.

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  • TB infection prevalence and skin test conversion rates were analyzed.

    • Main Results:

    • High rates of TB skin testing were reported for initial employment (98%) and annually (97%) for employees, and for newly admitted residents (56% routine, 18% conditional).
    • Less than half of facilities correctly interpreted reactive TB skin tests based on induration diameter.
    • Booster testing was infrequently performed (6% for new employees, 6% for new residents).
    • TB infection prevalence was 8.1% in new employees and 6.4% in new residents; five-year mean conversion rates were 1.1% for employees and 0.9% for residents.

    Conclusions:

    • Significant lack of compliance with established TB skin-testing guidelines was observed in North Carolina LTCFs.
    • Inconsistent application of TB skin-testing protocols, particularly in test interpretation and booster test use, poses a risk for TB transmission.
    • Implementation of standardized and guideline-adherent TB screening practices for both residents and employees in LTCFs is strongly recommended to mitigate TB spread.