The prevalence of pulmonary tuberculosis using different methods in group screenings

Abstract

In order to find the most precise and practical procedure to record the prevalence of tuberculosis in group screenings, 7405 students staying at Hacettepe University dormitories between 1984 and 1987 were screened by 3 different methods used in tuberculosis screening, namely microfilms, tuberculin tests and tuberculosis symptoms (cough, hemoptysis, weight loss, etc). The average sensitivity of these tests were found to be as follows: microfilm 6.3%, tuberculin 45.8%, screening of tuberculosis symptoms 60.4%. The most ideal tuberculosis group screening method was found to be detailed examination of cases with symptoms of tuberculosis plus cases who are at the pathological border in tuberculin skin tests (with BCG inoculations > or = 20 mm and without BCG inoculation > or = 10 mm).

PIP: An estimated 1.7 billion individuals worldwide are infected with tuberculosis (TB), with more than 20 million having active TB disease. Annually, 8 million new cases appear and 3 million people die from the disease. In developing countries, TB may account for more than 25% of avoidable deaths between ages 15-59 years. Early diagnosis is key to successfully combatting TB. Microscopic examination of phlegm and cultivation of mycobacteria leads to definite diagnosis, but this approach is neither economical nor protocol in group screening. This study was therefore conducted to identify the most precise and practical procedure to record the prevalence of TB in group screenings. The author screened 7405 students residing in Hacettepe University dormitories over the period 1984-87 for TB using microfilms, tuberculin tests, and TB symptoms. Average sensitivities of the tests were as follows: microfilm, 6.3%; tuberculin, 45.8%; and screening of tuberculosis symptoms, 60.4%. Detailed examination of cases with symptoms of TB plus cases at the pathological border in tuberculin skin tests therefore proved to be the most ideal TB group screening method.