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Article
December 27, 1995

Screening for Tuberculosis

Author Affiliations

US Embassy Cairo, Egypt

JAMA. 1995;274(24):1912-1913. doi:10.1001/jama.1995.03530240022029
Abstract

To the Editor.  —The study of tuberculosis (TB) screening of schoolchildren by Dr Mohle-Boetani and colleagues1 highlights targeted screening of non—US-born children as a cost-effective mechanism to detect and treat TB infection. In the accompanying Editorial, Dr Starke2 reinforces this finding with multiple studies that document the high tuberculin skin test reactivity in non—US-born children. Both articles are compassionate and realistic in their concern about stigmatization of the target groups as an impediment to effective public health programs.Stigmatization occurs because a new population—immigrants attempting to blend into the resident population of the United States—is identified with a negative attribute, TB infection. Targeting part of an already blended population guarantees stigma. Unfortunately, a school examination is commonly the first time a new immigrant child is evaluated for TB. This situation is complicated by our current immigration medical screening system, which has no functioning mechanism to test anyone younger

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