MANTOUX (TUBERCULOSIS) TESTING - EVALUATION OF GUIDELINES FOR TESTINGIN CANADIAN INSTITUTIONS

OBJECTIVE To evaluate the guidelines for Mantoux testing and isoniazid (INH) prophylaxis in various institutions and shelters for the homele ss in Canada in light of research in Canada and other industrialized c ountries. DATA SOURCES MEDLINE searches from January 1980 to June 1996 yielded 219 articles, some of which were case reports. The bibliograp hies of these articles were searched for relevant titles. A further se arch adding the words randomized, controlled trial and controlled clin ical trial yielded two citations, neither of which was a randomized, c ontrolled trial. DATA EXTRACTION Studies were included if they describ ed the incidence, screening, diagnosis, or prophylaxis of tuberculosis (TB) in institutions in Canada. DATA SYNTHESIS Studies of staff and p atients in institutions tend to be incomplete in reporting exposure to TB, extent of Mantoux testing, and whether INH prophylaxis was comple ted. CONCLUSIONS Institutions admitting patients with TB should follow the 1996 recommendations of the Canadian Thoracic Society (CTS). The best way to implement the recommendations is to have a TB control offi cer who administers protocols to identify staff and patients at risk f or TB and a committee that regularly monitors implementation of CTS gu idelines.