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.