title: Changes in tuberculin sensitivity among first-grade students of elementary schools in Evros, Greece due to immigration.
abstract: OBJECTIVE
  To investigate the tuberculin sensitivity trends among first-grade students of elementary schools tested according to the Greek national school-based screening and vaccination programme.
  
  
  METHODS
  Retrospective analysis of tuberculin skin test (TST) results from 1988 to 2004 in unvaccinated first-grade students in Evros, Greece.
  
  
  METHODS
  All 6-7-year-old children who were unvaccinated for tuberculosis were tested by a highly experienced team. This study tested whether gender (male vs female), national origin (native vs foreign-born children) and place of residence (urban vs semi-urban vs rural) correlated with tuberculin reaction positivity.
  
  
  RESULTS
  In total, 8588 children (47.1% girls) were tested. Tuberculin reaction positivity was independent of gender. The difference in TST positivity between native and foreign-born children between 1993 and 2004 was highly significant, with substantially more foreign-born children having a positive Mantoux test (P<0.0001). The percentage of children with a positive TST peaked at 13% in 1995 due to initial admission of foreign-born children, originating from countries of the former Soviet Union, into the Greek educational system. In addition, a positive Mantoux test was more common among children living in rural (8.1%) and semi-urban (6.4%) areas compared with children living in urban areas (3.5%, P<0.0001).
  
  
  CONCLUSIONS
  The increase in TST positivity noted was due to admission of foreign-born children into the Greek educational system. School-based tuberculosis screening programmes should continue in Greece because the prevalence of tuberculosis appears to show substantial variation between years.
authors.affiliation: Department of Paediatrics, Democritus University of Thrace, 68 100 Alexandroupolis, Thrace, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Mantadakis
authors.forename: V
authors.initials: V
authors.lastname: Arvanitidou
authors.forename: A
authors.initials: A
authors.lastname: Tsalkidis
authors.forename: A
authors.initials: A
authors.lastname: Ramatani
authors.forename: E
authors.initials: E
authors.lastname: Triantafillidou
authors.forename: G
authors.initials: G
authors.lastname: Trypsianis
authors.forename: V
authors.initials: V
authors.lastname: Dipla
authors.forename: S
authors.initials: S
authors.lastname: Thomaidis
authors.forename: D
authors.initials: D
authors.lastname: Bouros
authors.forename: A
authors.initials: A
authors.lastname: Chatzimichael
mesh_terms: D002648:Child; D004641:Emigration and Immigration / Q000706:statistics & numerical data*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D011159:Population Surveillance; D015995:Prevalence; D012189:Retrospective Studies; D012574:Schools; D012680:Sensitivity and Specificity; D013334:Students; D014374:Tuberculin Test / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014611:Vaccination / Q000706:statistics & numerical data