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Current tuberculosis screening practices
American Journal of Public Health
|December 1, 1984
Summary
Tuberculosis screening practices in the US largely follow expert guidelines, but chest X-rays are overused. Further evaluation is needed to optimize productive screening programs for high-risk individuals.
Area of Science:
- Public Health
- Infectious Disease Control
- Epidemiology
Background:
- Tuberculosis (TB) remains a significant public health concern globally and in the United States.
- Effective screening programs are crucial for early detection and prevention of TB transmission.
- High-risk populations require targeted screening strategies to maximize resource efficiency.
Purpose of the Study:
- To assess current tuberculosis screening practices across state and city health departments in the US.
- To identify adherence to recommended screening guidelines from authoritative bodies.
- To uncover potential areas for improvement in TB screening program efficiency and effectiveness.
Main Methods:
- A survey questionnaire was distributed to health department officials in all 50 states and 14 major US cities.
- Data collected focused on the target populations for screening, methods employed, and regulatory mandates.
- Responses were analyzed to evaluate current screening protocols and identify deviations from established guidelines.
Main Results:
- Screening efforts primarily target populations identified as high-risk by the American Thoracic Society (ATS) and Centers for Disease Control (CDC).
- Screening methodologies generally align with recommendations from ATS, CDC, and the Food and Drug Administration (FDA), with noted overuse of chest radiographs.
- Approximately half of the surveyed groups have legally mandated screening, and there is observed confusion regarding the appropriate use of two-step tuberculin testing.
Conclusions:
- Current TB screening practices in the US show considerable alignment with expert recommendations for high-risk groups.
- Overutilization of chest radiographs and confusion surrounding specific testing protocols indicate areas needing clarification and potential modification.
- Limited data on productivity and costs necessitate a call for rigorous evaluation and optimization of TB screening programs to enhance their effectiveness and efficiency.