Targeted Testing of Children for Tuberculosis: Validation of a Risk Assessment Questionnaire

Froehlich, Hervey; Ackerson, Lynn; Morozumi, Pius A.

doi:10.1542/peds.107.4.e54

Cited by 56 publications

(60 citation statements)

References 23 publications

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“…The TB risk factor questionnaire contained questions about demographics, TB exposure, work history, location of residence, and other factors shown in Table 1. This questionnaire was developed from the risk factors previously identified in the military and nonmilitary literature (20)(21)(22)(23)(24)(25), and other factors considered candidates for causal relationships with LTBI.…”

Section: Study Methodology and Proceduresmentioning

confidence: 99%

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Mancuso

Mazurek²,

Tribble³

et al. 2012

Am J Respir Crit Care Med

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Section: Study Methodology and Proceduresmentioning

confidence: 99%

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Mancuso

Mazurek²,

Tribble³

et al. 2012

Am J Respir Crit Care Med

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“…In this population, bacillus Calmette-Guérin (BCG) immunization, a TST within 12 months, and a relative with a positive TST were risk factors for a positive TST (Ն10 mm). Froehlich et al 20 performed a study to determine if a risk-assessment questionnaire could predict a positive TST in children in northern California and found that foreign birth, BCG immunization, living outside the United States, Asian or Hispanic ethnicity, or contact with a household member with TB disease or LTBI were independent predictors of LTBI.…”

Section: Screening Children and Adolescents For Risk Factors For Ltbimentioning

confidence: 99%

“…Howard and Solomon 98 demonstrated that 63% (133 of 212) of patients with positive TSTs did not report induration, although 99% (520 of 525) of those with negative TSTs correctly interpreted their skin test as negative. Froehlich et al 20 compared TST readings by parents and health care professionals. Parents failed to detect 9.9% of positive TSTs when using the 10-mm cutoff level (1% of cohort) and 5.9% of positive TSTs when using the 15-mm cutoff level (0.5% of cohort).…”

Section: Interpretation Of the Tst By Trained Health Care Workersmentioning

confidence: 99%

Targeted Tuberculin Skin Testing and Treatment of Latent Tuberculosis Infection in Children and Adolescents

2004

Pediatrics

110

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ABSTRACT.Comprehensive new guidelines for screening, targeted testing, and treating latent tuberculosis infection (LTBI) in children and adolescents are presented. The recent epidemiology of TB and data on risk factors for LTBI are reviewed. The evidence-based recommendations provided emphasize the paradigm that children and adolescents should be screened for risk factors by using a risk-factor questionnaire for TB and LTBI and tested with the tuberculin skin test only if >1 risk factor is present. The use of administrative or mandated tuberculin skin tests for entry to day care, school, or summer camp is strongly discouraged. Treatment regimens, suggestions to improve adherence, and methods to monitor toxicities are summarized. Children and adolescents with LTBI represent the future reservoir for cases of TB. Thus, detecting and treating LTBI in children and adolescents will contribute to the elimination of TB in the United

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“…Previously, questionnaire studies have been done to assess risk factors for a positive TST in pediatric populations consisting of the middle-class insured and those of low-income, mixed ethnicity. [15][16][17][18] The main goals of our study were to (1) identify factors that are associated with a positive TST in a Mexican immigrant population; (2) evaluate Bacille Calmette-Guérin (BCG) vaccine history affect on TST results; and (3) determine whether a history of foreign visitors to the child's home, family or child travel to Mexico, and cumulative length of time of these exposures to potential active TB cases increases risks for a positive TST. …”

mentioning

confidence: 99%

Risk Factors Associated With Latent Tuberculosis Infection in Mexican American Children

Young

O’Connor

2005

Pediatrics

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ABSTRACT. Objectives. To determine risk factors that are associated with the presence of latent tuberculosis infection (LTBI) in Mexican American children.Methods. In this prospective cohort study, we administered tuberculin skin tests (TSTs) and a tuberculosis (TB) risk factor questionnaire to children who were aged 1 to 18 years in immigrant families at a Denver inner-city community health center and elementary school-based health center. Information requested on the questionnaire included child demographics, child and parent birth location, Bacille Calmette-Guérin (BCG) vaccination, and a history and the duration of child and family travel to and visitors from countries where TB is endemic. TST results were read at 48 to 72 hours and were interpreted as positive at 5-and 10-mm induration, depending on risk factor history. All participants received $5 coupons on return for TST reading.Results. Of 584 children enrolled, 96% returned for TST evaluation, median age was 4 years, 48.6% were male, 98.5% were Latino, 66.3% were born in the United States, and 33% were born in Mexico. Overall, 12. Conclusions. In a population of primarily Mexican American children, those who were born in the United States had an increased risk for developing LTBI when they had a history of BCG vaccination or had traveled to Mexico. For children who were born in Mexico, we were unable to identify additional risk factors for the presence of LTBI, besides their birth in Mexico. Incentives for return for TST reading, such as grocery coupons, are highly effective. Identifying active TB in immigrants is not always straightforward. Many immigrants from high-risk countries, particularly children, do not immigrate with symptomatic TB disease. Instead, they come to the United States with latent TB infection (LTBI), having no symptoms of active TB disease but harboring the risk for activating and becoming infectious at some time in their lives. LTBI is diagnosed when a child or an adult has a positive tuberculin skin test (TST) and a normal chest radiograph and are asymptomatic. 3 Children with a positive TST most likely have an equivalent lifetime risk for developing active disease compared with most adults. 4 Risks for a child with LTBI for developing active TB include stressors such as going through an adolescent growth spurt and the development of chronic diseases such as diabetes. 3 TB infection in children represents more recent exposure than in many adults and therefore is indicative of recent TB transmission. 5 children who were younger than 5 years and had active TB found that for the children in whom a source could be identified by genotyping and public health investigation, 51% of the identified source cases were foreign born. 6 In adult immigrants, the first 5 years after immigration carries the highest risk for developing active TB. This probably reflects that acquisition of TB infection most often occurs before immigration. 7,8 This has been supported by several molecular epidemiologic studies that have shown that isolates of activ...

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Targeted Testing of Children for Tuberculosis: Validation of a Risk Assessment Questionnaire

Cited by 56 publications

References 23 publications

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Discordance among Commercially Available Diagnostics for Latent Tuberculosis Infection

Targeted Tuberculin Skin Testing and Treatment of Latent Tuberculosis Infection in Children and Adolescents

Risk Factors Associated With Latent Tuberculosis Infection in Mexican American Children

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