TUBERCULIN SKIN-TEST SCREENING IN SCHOOLCHILDREN IN THE UNITED-STATES

Objective. To determine the current practices and results of tuberculi n skin test (TST) screening of schoolchildren in the United States. Me thods. Tuberculosis program staff in all states and the District of Co lumbia were asked about current requirements, practices, and results o f school-based TST screening. Results. Thirty-four states and the Dist rict of Columbia (69%) reported no current statewide statutes or polic ies for tuberculin screening of schoolchildren, and 10 (19%) reported having statewide requirements. In 6 states (12%), requirements were in stituted at the local level, and 24 localities in these states were kn own to require screening. Of the 34 areas requiring screening, 18 (53% ) screened all new entrants, 7 (21%) screened children in specific gra des, and 9 (26%) used other criteria for screening. TST results were c ollected for 26 (76%) of 34 areas, and 6 areas collected results of fo llow-up evaluation of tuberculin-positive children. Additionally, 8 lo calities in 7 states with no screening requirements conducted tubercul in surveys. Sixteen areas provided results. In 7 of the 8 areas that c ollected information about birthplace, less than 2% of US-born childre n were tuberculin positive; foreign-born children had rates 6 to 24 ti mes higher than US-born children. TST screening identified few cases o f tuberculosis, less than 0.02% of the children screened. Conclusion. School-based tuberculin screening identified low rates of positive TST results in US-born children. Resources should be directed toward scre ening children at high risk for tuberculous infection, as recommended by the American Academy of Pediatrics and the Advisory Committee for E limination of Tuberculosis.