Screening People in Contact With Children May Help Prevent Tuberculosis
WebMD News Archive
"Contact screening was not effective in identifying undiagnosed active
cases, but it was highly effective in identifying tuberculin-positive
candidates for preventive therapy," says Karen Soren, MD, the study's lead
researcher and assistant professor of pediatrics at Columbia University.
"So the study has policy implications for tuberculosis prevention efforts
in high-risk populations."
The chief investigator of a similar study agrees. "We studied contact
screening in San Francisco with an Asian population and our findings were
comparable," says Paul Sullam, MD, an infectious diseases specialist and
associate professor of medicine at University of California, San Francisco.
"Contact screening may well be a good strategy, but it's got to be
cost-effective because resources are limited. As a next step, we ought to look
at the potential cost savings of contact screening."
"Some of our data depends on the verbal reports of participants, and
this is certainly a limitation of the study. We found a very low incidence of
IV drug abuse, HIV infection, and jail history, which are all associated with
TB," says Soren. "And it's entirely possible that these risk factors
were underreported. It's also possible that some skin tests were positive due
to the boosting effect of BCG vaccinations." Controlling for these
variables in the future will help validate and expand the body of data.
The study was supported by the New York State Department of Health, the
Center for Community Health, and the National Institutes of Health.
- People who have been in contact with someone infected with TB can be
screened to determine whether they have been exposed to the disease.
- In a recent study, no active cases of TB were identified during contact
screening, but more than 30% of contacts had positive skin tests, making them
eligible for preventive therapy.
- Further research is needed to determine whether contact screening is
cost-effective and is a reasonable allocation of resources.