To the Editor.—
We enjoyed the timely report by Drs Catanzaro and Moser (1982;247:1303) of their observations regarding the health status of various ethnic groups of Indochinese refugees. These authors noted a positive tuberculin skin test result in 57% of 356 Cambodian refugees screened at the Center for Indochinese Health Education, University of California, San Diego Medical Center. It is probable that the rates of tuberculin reactivity found would be different had testing been performed that would allow for inclusion of refugees who might have demonstrated the "booster effect."1The Jefferson County (Alabama) Department of Health has provided health screening for more than 200 Vietnamese and Cambodian refugees since October 1980. A positive tuberculin test result (single tuberculin test performed) occurred at an average rate of 50% among all Indochinese. Following the report from New York2 in late 1981 describing apparent tuberculin conversion among refugees, we conducted "two-step"
Alexander WJ, Harden JW, Weeks JD, Roper WL. 'Boosted' Tuberculin Reactions Among Cambodian Refugees. JAMA. 1982;248(10):1177. doi:10.1001/jama.1982.03330100017010
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