Moving toward tuberculosis elimination: implementation of statewide targeted tuberculin testing in Tennessee

American Journal of Respiratory and Critical Care Medicine
Kevin P CainC A Haley

Abstract

From 1993 to 2010, annual U.S. tuberculosis (TB) rates declined by 58%. However, this decline has slowed and disproportionately occurred among U.S.-born (78%) versus foreign-born persons (47%). Addressing the high burden of latent TB infection (LTBI) must be prioritized. Only Tennessee has implemented a statewide program for finding and treating people with LTBI. The program was designed to address high statewide TB rates and growing burden among the foreign-born. We sought to assess the feasibility and yield of Tennessee's program. Analyzing data from the 4.8-year period from program inception in March 2002 through December 2006, we quantified patients screened using a TB risk assessment tool, tuberculin skin tests (TST) placed and read, TST results, and patients initiating and completing LTBI treatment. We then estimated the number needed to screen to find and treat one person with LTBI and to prevent one case of TB. Of 168,517 persons screened, 102,709 had a TST placed and read. Among 9,090 (9%) with a positive TST result, 53% initiated treatment, 54% of whom completed treatment. An estimated 195 TB cases were prevented over the 4.8 years analyzed, and program performance measures improved annually. The number of TSTs placed...Continue Reading

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Citations

Aug 3, 2012·American Journal of Respiratory and Critical Care Medicine·Randall R Reves, Charles M Nolan
Oct 17, 2013·American Journal of Respiratory and Critical Care Medicine·Dick Menzies, Payam Nahid
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