Detection of tuberculosis (TB) infection among adolescents appears to have declined in high-risk communities since universal TB skin testing was replaced by screening questions designed for provider use to determine risk. To examine effectiveness of this new targeted screening policy and to increase TB awareness among high-risk students and families, we administered TB risk assessment questionnaires anonymously to 9th graders and their parents in three inner-city public high schools. Students and parents were also asked about frequency of routine health maintenance visits, TB risk assessments, and TB skin testing. Of 578 students (95% response rate), 436 (75%) claimed at least one TB infection risk factor. Although 468 (81%) students recalled having annual physical exams, only 128 (22%) recalled being asked TB risk assessment questions and only 231 (40%) recalled undergoing skin testing during the previous year. Of 207 parents (34% response rate), 125 (60%) claimed their children had at least one TB infection risk factor. Although 177 (86%) recalled their children had annual physical exams, only 46 (22%) recalled being asked TB risk assessment questions about their children and only 118 (57%) recalled their children undergoing skin testing during the previous year. Student and parent responses to all questions were in marginal to good agreement (k=0.067 - 0.610). A large disparity exists between being at risk for TB infection and actually receiving recommended skin testing. Given these results, improved provider acceptance of targeted testing principles, or universal screening of students in certain school areas may be merited.
Learning Objectives: At the conclusion of the session the participant (learner) in this session will be able to: 1. Identify five risk factors for tuberculosis (TB) infection which mandate skin-testing of individuals for TB. 2. Describe the disparity between being at-risk for TB infection and actually receiving appropriate screening. 3. Discuss ways in which to increase levels of appropriate screening of at-risk adolescents for TB.
Keywords: Adolescent Health, TB
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.