School-based study to identify and treat adolescent students at risk for tuberculosis infection

Lindsay A. Hatzenbuehler, Jeffrey R. Starke, Edward A. Graviss, E. O Brian Smith, Andrea T. Cruz

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Screening for and treating tuberculosis (TB) infection in children and adolescents is an effective way of decreasing future TB cases. However, current approaches leave many children at risk for TB unidentified. Methods: We recruited adolescent students from 2 public high schools (a magnet and a low-income) in the Houston Independent School District. Compared with the magnet school, the student population at the low-income school was larger, primarily Hispanic and economically disadvantaged. Students were educated about TB, and parents completed a risk factor questionnaire. Students with TB risk factors were tested using 2 interferon gamma release assays (IGRAs). Those with a positive IGRA received a 12-dose regimen of weekly isoniazid/rifapentine (3HP) administered via direct observation at school. Results: Nine hundred twenty-five students received TB education; 73% of their parents submitted the TB questionnaire. Eighty-six percent of students (n = 415) with a TB risk factor identified on the study questionnaire agreed to IGRA testing. Sixteen students had at least one positive IGRA (1% [magnet], 4.1% [low-income]; P = 0.005). Recent student travel to a high-risk country (7) or contact with TB disease (2) were associated with IGRA positivity (P < 0.05). All students with a positive IGRA accepted, tolerated and completed 3HP treatment at school. Conclusions: School-based TB education, screening, testing using IGRAs and administration of 3HP treatment is feasible to improve the identification and treatment of adolescent students at risk for TB.

Original languageEnglish (US)
Pages (from-to)733-738
Number of pages6
JournalPediatric Infectious Disease Journal
Volume35
Issue number7
DOIs
StatePublished - Jul 1 2016

Keywords

  • directly-observed therapy
  • interferon gamma release assay
  • isoniazid-rifapentine
  • latent tuberculosis infection
  • school-based tuberculosis screening

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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