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Routine tuberculin screening of children during hospitalization

G E Schutze1, T D Rice, J R Starke

  • 1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.

The Pediatric Infectious Disease Journal
|January 1, 1993
PubMed

Insights

Routine tuberculosis screening for hospitalized children in high-risk Houston, Texas, identified few new infections. This study suggests hospital-based screening may not be an effective strategy for detecting childhood tuberculosis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Harris County, Texas, including Houston, exhibits high childhood tuberculosis (TB) case rates.
  • Tuberculosis remains a significant public health concern, particularly in pediatric populations.

Purpose of the Study:

  • To evaluate the effectiveness of routine tuberculin skin testing during hospitalization for acute medical care in children.
  • To determine if hospital admission is a suitable setting for identifying asymptomatic tuberculous infections in children.

Main Methods:

  • A 11-week screening program was conducted in spring 1988 at Ben Taub General Hospital, Houston, TX.
  • All children admitted to the medical service received a Mantoux tuberculin purified protein derivative skin test.
  • Data collection focused on evaluable skin test results at 48 hours.

Main Results:

  • A total of 432 children were skin tested; 50% were under one year of age.
  • Only 304 patients had evaluable results at the 48-hour mark.
  • Two new positive tuberculin skin tests were identified, yielding a positive rate of 0.66%.

Conclusions:

  • Routine tuberculin screening of all hospitalized children in a high-risk region yielded a low positive rate.
  • The study suggests that inpatient pediatric medical services may not be an effective or efficient setting for routine tuberculosis screening.
  • Alternative or targeted screening strategies may be more appropriate for identifying pediatric tuberculosis infections.

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