Can We Improve the Return Rate for Tuberculin Skin Test Readings?

Tuberculosis continues to cause disease in the United States despite effective treatment and a simple screening test. The Pediatric Practice of Rainbow Babies and Children’s Hospital, a tertiary care children’s hospital in Cleveland, Ohio, serves an inner-city population. It is located in Cuyahoga County, which had the highest number of reported tuberculosis cases in Ohio in 2003.¹ The Pediatric Practice follows American Academy of Pediatrics recommendations for targeted tuberculin skin testing by screening all children by questionnaire to identify high-risk patients.² Children with positive screening questionnaires have a tuberculin skin test placed, receive a reminder card, and are asked to return in 48 to 72 hours without an appointment required. The return rate is approximately 50%, lower than desired but similar to that of other studies with comparable populations.^3- 5 Ozuah and colleagues⁵ have shown previously that an additional telephone call increases the return rate at 72 hours.