Although this is less than optimum, it must be remembered that this is a population that is in danger of receiving no screening at all. This method results in considerable cost savings and uses the nursing staffs limited time more efficiently than if chest roentgenograms alone are used on all patients, yet it yields more information.
A compelling justification for routine tuberculosis screening in our obstetric patient population and for hospitals serving similar high-risk populations is for public health concerns. The only contact many young women have with the health care system is for obstetric care. Large numbers of women infected with Af tuberculosis who would not otherwise be screened can be identified. Screening of this population also is logical because virtually all of the tuberculin reactors identified will be 35 years of age or less and thus will be candidates for intervention with isoniazid.
The Centers for Disease Control has set a goal of eliminating tuberculosis in the United States by the year 2010 and suggested that as part of this effort each person in the United States have the results of a TBN-ST in his or her medical records. As the amount of funds available for tuberculosis programs is decreasing, it is unlikely that universal screening will occur, despite the recommendation of the Centers for Disease Control.