RADIOGRAPHIC SCREENING FOR TUBERCULOSIS IN A LARGE URBAN COUNTY JAIL

Objective. This study was designed to evaluate an innovative program o f high speed radiographic screening for pulmonary tuberculosis (TB) at a large urban correctional institution, Cook County Jail in Chicago. Methods. From March 1992 to February 1994, 126,608 inmates were screen ed on in-take with a 100-mm mini-chest radiograph. Results. Sixty-seve n cases of active TB were identified by radiograph and 19 others from diagnostic work-up. The case finding rate for active disease with radi ographic screening was approximately double the rate previously achiev ed with Man-tour skin testing. Mean time from jail entry to isolation was reduced from 17.6 days with Mantoux skin testing to 2.3 days with radiographic screening. Conclusions. In large jail facilities, high sp eed X-ray screening for TB can minimize disruption of the intake proce ss and lead to dramatic improvements in the efficiency of medical foll ow-up and isolation.