Screening for pulmonary tuberculosis using chest radiography in new employees in an industrial park in Taiwan

Shih-Bin Su, MD, MS,a,b Chien-Fang Chiu, MD,a Cheng-Ta Chang, MD,c Kow-Tong Chen, MD, PhD,d
Ching-Yih Lin, MD,e and How-Ran Guo, MD, MPH, ScDb,f
Tainan, Taiwan
Background: Pulmonary tuberculosis (TB) is prevalent in Taiwan, but it is suspected that its occurrence has been underestimated
by the National TB Surveillance Program. A pre-employment health examination is mandated by law in Taiwan, providing a mechanism
to assess the occurrence of TB more accurately.
Methods: A pre-employment TB screening program of an industrial park was used to evaluate the performance of the National TB
Surveillance Program in Taiwan. The yields of the pre-employment TB screening, using chest radiography from July 2004 to June
2005, were compared with corresponding results of the National TB Surveillance Program.
Results: A total of 17,105 new employees with an even gender distribution (men:women ratio, 50.2%:49.8%) underwent screening
during the study period. Among the participants, 22 (128.6 per 100,000) new patients with pulmonary TB were diagnosed, and
7 (31.8%) of the patients had positive bacteriology findings. Compared with the results of the National TB Surveillance Program,
the pre-employment screening had a much higher yield (128 vs. 47 per 100,000, P , .001).
Conclusion: The yield of the active surveillance program through mandatory screening was much higher than that of the National
TB Surveillance Program, which is a passive reporting system. The results of this study highlight the need for more active TB surveillance
efforts in endemic areas like Taiwan. (Am J Infect Control 2007;35:254-9.)