Abstract
In the past 10 years, I have cared for more than 500 children and adolescents with tuberculosis. Only one of them—an asymptomatic 5-year-old with mild hilar adenopathy—was discovered via a school skintesting program, although since 1990, the Houston Independent School District has required all new entrants to have a tuberculin skin test. During the last 5 years, the number of children in Houston with tuberculosis has increased. School-based skin testing has neither found many active cases nor prevented their occurrence. At first glance, requiring all schoolchildren to have a tuberculin skin test seems to be a reasonable response to the desire to promote prevention of a potentially serious and still prevalent disease.
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