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Journal of Correctional Health Care
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Two-Stage Tuberculin Testing in a Prison Population

Charles F. "Tim" Brady, DO, MPH

Department of Occupational and Environmental Medicine, University of Texas Health Science Center, Texas Institute for Occupational Safety and Health, 11937 US Highway 271, Tyler, TX 75708-3154. Phone: (903) 877-7262.

Steven S. Spencer, MD, FACP, CCHP-A

In the New Mexico Corrections Department, mass screening of male inmates revealed a purified protein derivative of tuberculin (PPD) conversion rate of 3.9 percent and led to the institution of two-stage skin testing of all new inmates. This policy change resulted in a drop of the annual conversion rate to O.9 percent. An analysis of the two-stage testing program showed that of 518 subjects classified as PPD positive, 121 were so classified on the basis of a documented history of a prior positive test, and 397 underwent the two-stage protocol. Of these, 273 (69%) had a significant reaction to the first test. The remaining 124 (31%) required the booster effect of the first test and had significant reactions only to the second test. Two-stage testing is recommended for new inmates of long-term correctional facilities, in order to establish accurate baseline information and to avoid the trap of false converter rates.

Journal of Correctional Health Care, Vol. 7, No. 2, 163-188 (2000)
DOI: 10.1177/107834580000700201
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