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

¹ Lexington, Kentucky

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.

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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.