Two-step PPD testing results surprising
A review of a two-step purified protein derivative (PPD) screening program among new employees at the Missouri Department of Corrections found a higher number of boosted PPD-positive employees than expected.After the first 14 months of the program, health officials found 7.9% or 79 new employees were infected with TB. Less than half — 2.5% or 24 people — tested positive on the first test, while 3.1% boosted positive for the second test.
Two-thirds of the boosted positives were 0 mm initially, six were 1-10 mm, and four were 11-15 mm. The majority of employees were male, in their 30s, in good health, and had military experience, which was their only risk factor for exposure.
Surprised by the boosting effect among this population, the authors of the study conclude that two-step testing may be more beneficial or cost-effective in populations under 55 years old than might be expected.
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