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March 2006

Commentary on the Risk of Active Tuberculosis

Arch Pediatr Adolesc Med. 2006;160(3):317-318. doi:10.1001/archpedi.160.3.317

One of the fundamental questions in tuberculosis (TB) control is the optimal interpretation of the tuberculin skin test (TST) when it is administered to apparently healthy persons. The answer has far-reaching consequences: for the individual patient, a diagnosis and a treatment plan; and for public health, guidance about who should be tested and treated for asymptomatic infection with Mycobacterium tuberculosis, or latent TB infection (LTBI). If vaccination with BCG is known or presumed, then the solution is complicated by the inconsistent BCG influence on TST results and the unpredictable but generally poor efficacy of this vaccine. In this issue of ARCHIVES, Leung et al add to our knowledge with their longitudinal study linking TST results to subsequent TB disease in schoolchildren in Hong Kong.1