Manusov E G, Bradshaw R D, Fogarty J P
Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md, USA.
Fam Med. 1996 Oct;28(9):645-9.
The Liaison Committee on Medical Education and the Association of American Medical Colleges have issued recommendations for screening medical students for tuberculosis. This report describes the initiation of a tuberculosis screening program at the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences (USUHS).
A screening program was instituted in 1993 that included intradermal purified protein derivative, the "booster phenomenon," inter-reader variability, risk factor analysis, and administrative policy to improve compliance.
There were 501 students screened (classes of 1996-1998). Initially, 19 (3.8%) students' tests were classified as positive, and 14 additional students tested positive when tested again 2 months later, due to the booster phenomenon. The subsequent conversion rate was 2.5% for those students who were followed for the next 3 years of medical school. All these students were placed on prevention therapy with isoniazid. No active cases of tuberculosis have been identified since the inception of the screening program.
Only recently has the importance of screening medical students been emphasized. The USUHS program was designed to address the factors for a successful screening program, such as increased compliance, standardization, and documentation. With modifications according to resources, medical schools can offer an efficient tuberculosis screening program to students, faculty, and staff.
医学教育联络委员会和美国医学院协会已发布关于对医学生进行结核病筛查的建议。本报告描述了在卫生科学统一服务大学（USUHS）的F. 爱德华·赫伯特医学院启动的一项结核病筛查项目。
1993年设立了一个筛查项目，包括皮内注射纯化蛋白衍生物、“增强现象”、阅片者间差异、风险因素分析以及旨在提高依从性的管理政策。
共对501名学生（1996 - 1998级）进行了筛查。最初，19名（3.8%）学生的检测结果被判定为阳性，2个月后再次检测时，由于增强现象，又有14名学生检测呈阳性。在医学院接下来的3年里对这些学生进行跟踪，其后续转化率为2.5%。所有这些学生都接受了异烟肼预防治疗。自筛查项目启动以来，未发现活动性结核病病例。
直到最近，医学生筛查的重要性才得到强调。USUHS项目旨在解决成功开展筛查项目的诸多因素，如提高依从性、标准化和记录。根据资源情况进行调整后，医学院可以为学生、教师和工作人员提供高效的结核病筛查项目。
