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Mantoux (tuberculosis) testing. Evaluation of guidelines for testing in Canadian institutions
1Elisabeth Bruyere Health Centre, Ottawa, ON.
Objective:
To evaluate the guidelines for Mantoux testing and isoniazid (INH) prophylaxis in various institutions and shelters for the homeless in Canada in light of research in Canada and other industrialized countries.
Data Sources:
MEDLINE searches from January 1980 to June 1996 yielded 219 articles, some of which were case reports. The bibliographies of these articles were searched for relevant titles. A further search adding the words randomized, controlled trial and controlled clinical trial yielded two citations, neither of which was a randomized, controlled trial.
Data Extraction:
Studies were included if they described the incidence, screening, diagnosis, or prophylaxis of tuberculosis (TB), in institutions in Canada.
Data Synthesis:
Studies of staff patients in institutions tend to be incomplete in reporting exposure to TB, extent of Mantoux testing, and whether INH prophylaxis was completed.
Conclusions:
Institutions admitting patients with TB should follow the 1996 recommendations of the Canadian Thoracic Society (CTS). The best way to implement the recommendations is to have a TB control officer who administers protocols to identify staff and patients at risk for TB and a committee that regularly monitors implementation of CTS guidelines.