Intensification of Tuberculosis Control Through a Community-Wide Approach: Rowan County, Kentucky

Abstract

Although a successful register-based tuberculosis control program had been in existence for several years, an attempt was made at intensification of the program through use of a community-wide school tuberculin skin testing program in a rural Appalachian county. Using the Sterneedle technique, with repeat testing of reactors with the Mantoux method, five new cases of tuberculosis were discovered — three among students, and two among their family contacts. These cases would not have been found routinely at this time under the traditional program. See Tables in the PDF File This is a new case discovery rate of 1.1 per 1,000 students tested and 12.2 cases per 1,000 contacts examined, at a cost of $258 per new case discovered. Three additional students with large tuberculin skin tests were placed on isoniazid prophylaxis. Intensification of the tuberculosis control program through the use of community-wide tuberculin skin testing on an organized basis and with adequate follow-up is an economic and productive case-finding tool in this rural area.