Tuberculin Skin Test Screening Practices Among US Colleges and Universities

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Abstract
TUBERCULOSIS on college and university campuses has been raised as a concern because of the large number of students who come from areas of the world where tuberculosis is common. In 1997, 39% of all tuberculosis cases in the United States occurred among foreign-born persons and, from 1986 through 1993, the tuberculosis case rate among foreign-born persons was 31 per 100,000, more than 5.5 times the rate among US-born persons.1,2 National tuberculosis surveillance data do not include information on whether a person with tuberculosis is a college or university student. However, from 1993 through 1997, a total of 7476 incident cases of tuberculosis (6% of all tuberculosis cases reported from 1993 through 1997) were reported in the United States among persons aged 18 through 24 years, the age group most likely to be in college (Centers for Disease Control and Prevention [CDC], unpublished data). Of these cases, 62% were foreign born; most came from 4 countries: Mexico (28%), Vietnam (14%), the Philippines (9%), and India (5%). Thirty-six percent of all foreign-born tuberculosis cases aged 18 through 24 years were diagnosed as having tuberculosis less than 1 year after entering the United States. Some of these persons may have been screened after arrival in the United States as a part of routine refugee or immigrant screening.