Tuberculosis Screening
The epidemiology of tuberculosis in a given community should be a major factor in determining tuberculosis screening programs. It can be argued that ideally every child should have a tuberculin skin test performed yearly, but the risk is so low in many suburban populations that the yield from such testing will be very low and the cost for each case found high. There is no question, however, about the need to have a systematic and complete screening in populations at high risk. These include inner city children, the socioeconomically disadvantaged, immigrants, health workers who come in contact with such populations, and all family and other close contacts of known cases. The tine test and other multiple skin puncture tests yield unacceptably high rates of false-positives and false-negatives. Intradermal tests are best, preferably with PPD, but of course these must be read by someone trained to evaluate reactions.
