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A Rapid Tuberculosis Screening Program for New Mothers Who Have Had No Prenatal Care (2)

Therefore, starting in the late 1970s, all women presenting for delivery who did not have a TBN-ST documented received a chest roentgenogram to screen for tuberculosis. This practice was expensive, timeconsuming and did not identify most patients who were infected with Mycobacterium tuberculosis and were candidates for isoniazid prophylaxis. The use of the chest roentgenogram for tuberculosis screening is thus less desirable from a public health perspective.
There have been reports suggesting that reading a TBN-ST at 24 h results in a sensitivity of over 80 percent when compared with the standard 48-h reading. Based in part on this information, in 1989 we established a Rapid Tuberculosis Screening Program for screening of this population. The program was designed with the goal of detecting patients infected with M tuberculosis. It is our belief that by doing so transmission to the child either in the perinatal period or in the future could be prevented. Additionally, we sought a reduction in the cost of the tuberculosis screening program.
Each patient was administered a symptom questionnaire upon admission to the labor and delivery area. All patients with a positive response received a chest roentgenogram before having contact with their babies. All patients with a negative symptom questionnaire had a TBN-ST performed while in the labor and delivery area. Prior to discharge, all patients with any induration due to the TBN-ST received a chest roentgenogram, even if 48 h had not elapsed since the test was done. In this study, we report our experience with this screening technique.

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