Enrollment in English-as-a-second-language class as a predictor of tuberculosis infection in schoolchildren.

OBJECTIVE: To assess the rate of tuberculosis infection among Hispanic students enrolled in English-as-a-Second-Language classes compared with Hispanic and non-Hispanic students not enrolled in such classes. METHODS: Using Mantoux tuberculin skin tests, the authors screened 720 students--out of 844 eligible--in two schools with predominantly Hispanic populations. Ethnicity and enrollment in the English-as-a-Second Language classes were recorded for each student. The rate of skin test positivity was compared for students enrolled and not enrolled in these classes. RESULTS: The incidence of positive tests among Hispanic students enrolled in an English-as-a-Second-Language class was 10.6%, compared with 1.3% for Hispanic students not enrolled (relative risk 8.3, 95% confidence interval 2.92, 23.8). There was no statistically significant difference in incidence rates for non-Hispanic students (0.5%) and Hispanic students (1.3%) who were not enrolled in English-as-a-Second-Language class (relative risk 2.4, 95% confidence interval 0.27, 20.9). CONCLUSION: School-based tuberculin screening programs targeted at students enrolled in English-as-a-Second-Language classes can be effective and are not racially discriminatory.

The evolution of targeted populations in a school-based tuberculin testing program.

A review of tuberculosis surveillance data from a program of school-based tuberculin testing demonstrates the natural evolution of targeted populations. In the 7 years encompassed by this study, the prevalence of tuberculin reactivity ranged from 4.3% to 6.1% in the Amarillo public school populations which were tested. The initial screening was a sampling of all students in the school district. In subsequent years' screening, the targeted populations were increasingly refined to eliminate lower-risk populations. Children enrolled in "English as a Second Language" (ESL) classes were found to have an 8.5% tuberculosis infection rate. The purpose of this study was to alert nurses that culturally sensitive approaches are needed for successful future testing.