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A Rapid Tuberculosis Screening Program for New Mothers Who Have Had No Prenatal Care (6)

Seventy-six patients were excluded from the study because the study protocol had not been followed up. One additional patient had an initial reading at 16 h of 18 mm of induration, while the patient had a 48-h reading of 0 mm of induration. A chest roentgenogram, however, showed changes consistent with prior tuberculosis. Because we suspect that the 48-h reading was in error, this patient s results were not included in the data analysis.
Forty-four patients gave a history of a positive TBN-ST or symptoms suggestive of active tuberculosis (Table 1). Each of these patients had a chest roentgenogram, two of which showed changes suggestive of tuberculosis. One of these patients, who had reported a history of drug-resistant tuberculosis and resectional surgery, was found to have active disease.
There were 1,412 patients who had a TBN-ST, 259 (18.3 percent) of whom were defined as reactors using a 5-mm induration cutoff for early readings (264 would have been defined as reactors using the original protocol). A chest roentgenogram was performed on 254 of the reactors, while five patients left the hospital before their chest roentgenograms could be done. Ten of the chest roentgenograms demonstrated findings suggestive of tuberculosis. None of these patients were found to have active disease.
The records of 116 women who delivered between June 26 and July 15, 1991, who had TBN-STs as part of their prenatal care were reviewed. Of these, 24 were positive, yielding a prevalence of tuberculin reactors of 20.7 percent among women who seek prenatal care.
One woman who had not received prenatal care was found to have active tuberculosis when she presented to the University of California, San Diego Medical Center, with hemoptysis in her second trimester and thus was not included in our study population. During the study period, one asymptomatic woman was found to have active tuberculosis during routine prenatal screening.

Table 1—-Positive Responses to the Symptom Questionnaire From 44 Patients

Symptom No.
History of positive TBN-ST 18
Chronic cough 16
Exposure to tuberculosis 10
Hemoptysis 5
Weight loss 5
Unexplained fever 3

Category: Pulmonary disease

Tags: chest roentgenograms, prenatal care, skin testing, tuberculin, tuberculosis

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