|
 Laboratory
Tests: Tuberculosis
(TB) Screening
Children at
high risk for tuberculosis include those born in countries where
TB is prevalent, those who are African American or Hispanic, and
those who are medically underserved.1,2 Poverty and
homelessness are among the factors contributing to the rising numbers
of TB cases in recent years. The incidence of tuberculosis in children
younger than 2 years is twice that in older children.1
 |
Periodicity
and Guidelines for Tuberculosis Screening |
HealthCheck
requires testing for TB with the Mantoux skin test (PPD) at key
developmental ages:
Infancy:
Early
Childhood:
- Test
at least once between 3 and 5 years
- If
child at high risk: Test between 15 and 24 months
Middle
Childhood:
- Test
annually, beginning at age 8
Adolescence:
Screening
Guidelines
- Test for
TB using the Mantoux method, an intradermal injection of positive
protein derivative (PPD).
- Provide prompt
treatment and additional evaluations annually for all children
or teens with positive test results.
- Maintain
complete documentation of all TB test results and follow-up evaluations
in the medical record.
Risk
Assessment
|
 Risk
Indicators for TB
|
- Contact with
adults with infectious TB
- Family immigration,
or travel in regions where TB is prevalent
- Abnormalities
on chest roentgenogram suggestive of TB
- Clinical evidence
of TB
- HIV-seropositive
status
- Immunosuppressive
conditions
- Other
medical risk factors (e.g., Hodgkins's disease, lymphoma,
diabetes
mellitus, chronic renal failure, malnutrition)
- Current or previous
incarceration
- Frequent exposure
to HIV-infected adults, homeless persons, injection drug
users, poor and medically indigent city dwellers, nursing
home residents, migrant farmers
|
References
1. U.S. Department
of Health and Human Services, Office of Disease Prevention and Health
Promotion. 1988. Put Prevention into Practice. Clinician's Handbook
of Preventive Services (2nd ed.). Washington, DC: Government Printing
Office.
2. Centers for
Disease Control and Prevention, Division of Tuberculosis Elimination.
TB Facts for Health Care Workers: Populations at Risk for Tuberculosis.
Available online at www.cdc.gov/nchstp/tb/faqs/tbfacts/population.htm.
Cited December 9, 2003.
Resources
Risk indicators
drawn from the Centers for Disease Control and Prevention and from
the American Academy of Pediatrics.
|
