Ayerbe Mateo-Sagasta M C, López-Hermosa Seseña P, Hernando Helguero P
Dirección Gerencia Atención Primaria, Móstoles, Madrid.
An Esp Pediatr. 1996 Nov;45(5):465-70.
To evaluate a screening program for tuberculosis (TBC) infection in a pediatric population in Spain using the tuberculin skin test (TST) and to analyze the distribution of the frequencies obtained.
The study consists of a descriptive analysis carried out on a sample of the pediatric population from Mostoles and Alcorcon, two towns belonging to the Community of Madrid with 192,353 and 141,292 inhabitants, respectively.
A sample of 2,369 children was analyzed. The TST was performed over a ten-month period by trained, voluntary nurses from primary care units. The following variables were analyzed: risk factors for TBC infection, BCG vaccination and induration (mm) of the TST. In children with positive TST results, a search for infective foci and active tuberculosis was performed.
The prevalence of TBC infection in the infantile population without risk factors was 0.7% (C.I. 95%, 0.4-1). No cases were found among children aged 3 months to 2 years. In the sample, 4.2% (C.I. 95%, 3.4-5) of the children had one or more risk factors for TBC-infection. Among children presenting risk factors for TBC, 5.1% (C.I. 95%, 1.6-11.8) had a positive result in the TST. However, 76.2% (C.I. 95%, 52.7-91.8) of children with a positive TST, no risk factors could be detected.
Although a positive TST was more frequent in children with risk factors, as the majority of children in our population lacked risk factors for TBC infection, selective screening based on this parameter would not detect most cases of TBC-infection. Greater efforts should be made to better identify children with risk factors for TBC. According to our results, it is highly advisable to perform the TST once during childhood between 10 and 14 years, the period of highest prevalence, for both epidemiological and clinical reasons.
