Screening for tuberculosis in the primary care setting.

Screening for tuberculous infection and active disease is an important part of primary care practice across the lifespan. It is estimated that between 10 and 15 million people living in the United States are infected with Mycobacterium tuberculosis. Specific ethnic groups and persons with medical comorbidities are at an increased risk for progressing to active disease. The Mantoux method using 5TU purified protein derivative (PPD) antigen solution is the recommended skin testing technique for all age groups and settings. Companion anergy testing is no longer widely recommended. Interpretation of the tuberculin skin test reaction is also specific to age, lifestyle, and medical or environmental risk factors. Evaluation of risk of tubeculosis in the refugee or immigrant population requires careful evaluation of risk factors and interpretation of screening tests.