Screening Latino adolescents for latent tuberculosis infection (LTBI).
OBJECTIVE
To investigate the rates of latent TB infection (LTBI) in a sample of young people in San Diego County and examine potential predictors of a positive tuberculin skin test (TST).


METHODS
Latino and foreign-born students from ten public middle and high schools were invited to screenings along with a random 10% sample of all other students. After obtaining parental consent, Mantoux tests were placed (N=2,698) and read (n=2,667 [98.9%]) in 48-72 hours. A positive TST was defined as > or =10 mm induration. The mean age of the sample was 14.34 years (SD=1.81); 50.1% were female (n=1,353); 78.5% were Latino (n=2,108); 35.7% were foreign-born (n=939); and 44.3% were uninsured (n=930).


RESULTS
The positive TST rate for Latinos was 21.8% vs. 5.6% for non-Latinos, p<0.001. Foreign-born Latinos had the highest infection rate (31.3%), followed by foreign-born non-Latinos (20.4%), U.S.-born Latinos (15.4%), and U.S.-born non-Latinos (1.0%), p<0.001. Logistic regression was conducted to determine predictors of TST positivity. Being Latino (odds ratio [OR]=3.27), uninsured (OR=1.60), foreign-born (OR=3.90), and living in the south county region closest to the U.S./Mexico border (OR=2.72) were significant predictors.


CONCLUSIONS
Results suggest that Latino youth near the California/Mexico border are at high risk for infection, for remaining undiagnosed, and for being under-treated for LTBI.
Sipan
Carol
C
Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 230, San Diego, CA 92123, USA.
Blumberg
Elaine
E
Hovell
Melbourne
M
Kelley
Norma
N
Moser
Kathleen
K
Ocaña
Miguel
M
Friedman
Lawrence
L
Acosta
Josephine
J
Vera
Alicia
A
Adams
Marc
M
D000293:Adolescent; D002140:California / Q000453:epidemiology; D003140:Communicable Disease Control; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D017058:Mexican Americans / Q000145:classification / Q000706:statistics & numerical data*; D016017:Odds Ratio; D033282:Parental Consent; D018579:Patient Selection; D015995:Prevalence; D012307:Risk Factors; D012494:Sampling Studies; D012574:Schools; D012985:Software Design; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control