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ARTICLE |

Screening for Tuberculosis FREE

Michael E. Fleenor, MD, MPH; Gwen Curtis
JAMA. 1995;274(24):1913-1913. doi:10.1001/jama.1995.03530240022030
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To the Editor.  —Those of us involved in TB control programs at the local level appreciate the implications of the cost-benefit analysis by Dr Mohle-Boetani and colleagues.1 Conducting more directed screening of childhood-aged subpopulations rather than routine mass screening of children at presumed high risk has become a much needed recommendation and has substantial cost savings to TB programs. We recently conducted a smaller analysis of the effectiveness of and cost to our local TB program in fulfilling the early periodic screening, diagnosis, and treatment (EPSDT) mandate to routinely screen children enrolled in Medicaid in the state of Alabama.During 1993 and 1994, Jefferson County Department of Health pediatric clinics performed 18441 EPSDT tine tests to screen for TB in children between the ages of 1 and 19 years. All patients with positive tine tests were retested by our TB staff using intermediate-strength purified-protein derivative (IPPD) tests. Only one

REFERENCES

Mohle-Boetani JC, Miller B, Halpern M, et al.  School-based screening for tuberculous infection: a cost-benefit analysis. JAMA . 1995;;274:613-619.
Health Care Financing Administration. Medicaid Manual, Part 5, Early Periodic Screening, Diagnosis and Treatment (EPSDT) . Washington, DC: Health Care Financing Administration; April 1995;. HCFA publication 45.5.
Medicaid Manual, State of Alabama, Early Periodic Screening, Diagnosis and Treatment (EPSDT) . Montgomery, Ala: Medicaid Agency of the State of Alabama; 1995;:14.
American Academy of Pediatrics, Committee on Infectious Diseases.  Screening for tuberculosis in infants and children. Pediatrics . 1994;;93:131-134.
 Medicaid program; third party liability (TPL) cost-effectiveness waivers. Federal Register . (July 10) , 1995;;60:35498-35503. Rules and Regulations.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Mohle-Boetani JC, Miller B, Halpern M, et al.  School-based screening for tuberculous infection: a cost-benefit analysis. JAMA . 1995;;274:613-619.
Health Care Financing Administration. Medicaid Manual, Part 5, Early Periodic Screening, Diagnosis and Treatment (EPSDT) . Washington, DC: Health Care Financing Administration; April 1995;. HCFA publication 45.5.
Medicaid Manual, State of Alabama, Early Periodic Screening, Diagnosis and Treatment (EPSDT) . Montgomery, Ala: Medicaid Agency of the State of Alabama; 1995;:14.
American Academy of Pediatrics, Committee on Infectious Diseases.  Screening for tuberculosis in infants and children. Pediatrics . 1994;;93:131-134.
 Medicaid program; third party liability (TPL) cost-effectiveness waivers. Federal Register . (July 10) , 1995;;60:35498-35503. Rules and Regulations.
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