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Current tuberculosis screening practices.

D E Snider, H R Anderson, S E Bentley

    American Journal of Public Health
    |December 1, 1984
    PubMed
    Summary
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    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.

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  • 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.