Prenatal purified protein derivative skin testing in a teaching clinic with a large Hispanic population

OBJECTIVE: The purpose of this study was to evaluate a tuberculosis skin te sting program in an outpatient obstetric teaching clinic. STUDY DESIGN: This was a retrospective chart review and economic analysis. Medical records of all patients in the clinic (n = 1763) who were delivered of infants between 1993 and 1997 were reviewed. Fifty-four percent of the patients were Hispanic, and 38% were white. Epi Info 6.0 (chi(2) analysis) was used to calculate statistical significance. RESULTS: Overall, 15.2% of the skin test results were positive. Positive te st results were found in 31.3% of Asians, 23.9% of Hispanics, 9.3% of black patients, and 4.1% of white patients. Hispanics had a relative risk for a positive purified protein derivative of 5.9 (3.9 to 8.8) compared with whit e patients. No chest x-ray films suggested active disease. CONCLUSION: Because the highest incidence of tuberculosis is in people of r eproductive age, an effective tuberculosis screening protocol during pregna ncy would be valuable in reducing the incidence of tuberculosis nationally. Projected savings of this program were $57,628.