Compliance to treatment of latent tuberculosis infection in a region of Israel.
BACKGROUND
One of the measures adopted in Israel since 1959 as part of the tuberculosis control program was screening children aged 12-13 years old. The screening comprised single-step tuberculin skin testing using the Mantoux method.


OBJECTIVE
To assess the efficacy of tuberculin skin screening for TB in schoolchildren in southwestern Israel as well as the compliance to treatment for latent tuberculosis infection.


METHODS
We retrospectively reviewed the records of children in the Ashkelon region who underwent a tuberculin skin test during the period 1995-99.


RESULTS
Of the 28,016 eligible children, 27,232 were tested. In 923 children, mostly from the former USSR and Ethiopia, an induration of 10 mm or more was found. Only 52 Israeli-born children tested positive. Tuberculosis was found in seven children with a positive test, five of whom were from Ethiopia. All children who tested positive were referred to the local TB clinic; only 266 children (28.8%) presented. Only 151 completed the recommended treatment of isoniazid for 6 months. Thus, although screening included most of the targeted children aged 13, only a third of them presented to a TB clinic, and of these only about half completed treatment for latent infection.


CONCLUSIONS
Our results indicate that the current policy of screening for latent TB in our region is ineffective in terms of implementation of the recommended treatment. We suggest that only high risk groups be screened, and that a concerted effort be made to implement treatment.
Bibi
Haim
H
Department of Pediatrics, Barzilai Medical Center, Ashkelon, Israel. haim_76407@yahoo.com
Weiler-Ravell
Daniel
D
Shoseyov
David
D
Feigin
Ilana
I
Arbelli
Yael
Y
Chemtob
Daniel
D
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D003140:Communicable Disease Control / Q000706:statistics & numerical data; D005002:Ethiopia / Q000208:ethnology; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D014586:USSR / Q000208:ethnology
D000995:Antitubercular Agents; D007538:Isoniazid