Author(s)
Eliza Sherman-Daniels (student)1
Salwa Raheel (student)1
Vincent Basso (student)1
Elena Uttaro MS 2
Katherine Kowalski 3
Christine Moronta 3
Neil Schluger MD (faculty)1
Marisa Montecalvo MD (faculty)1
3
Affiliation(s)
1 New York Medical College, School of Medicine, Valhalla NY, 105232 New York Medical College - School of Health Sciences & Practice,Valhalla NY, 105233 Health Services, New York Medical College, Valhalla NY, 10523
Abstract:
Tuberculosis (TB) remains a significant public health concern globally and in the United States. CDC guidelines recommend baseline TB testing for healthcare personnel at the time of hire, with further testing based on individual risk assessment rather than routine annual screening. Screening tests used are the tuberculin skin test (TST) and the interferon gamma release assay (IGRA). At New York Medical College (NYMC), medical and dental students are universally screened at matriculation and before entering their clinical years. The objective of this study is to describe the type of screening tests used, the prevalence of positive results at matriculation and post matriculation, and the subsequent management of positive tests including treatment for latent TB infection.
All students matriculating at the School of Medicine and the Touro College of Dental Medicine for the years 2018 through 2024 were included. TB screening and management data were obtained from New York Medical College’s Health Services records by Health Services nurse
practitioners and then de-identified. The data collected includes basic demographic information, presence of TB risk factors, screening test type, screening test result, and TB treatment associated with positive tests.
2464 students matriculated from 2018-2024 and 5729 TB screening tests were performed. The TB screening tests were 2646 (46%) TSTs and 3083 (54%) IGRA. 140 (5.7%) students had a record of a positive TST or IGRA; 106 of the 140 students had the positive TB screening test
before matriculation, and 34 after matriculation. Of these 34 students, 8 were deemed likely to have latent TB.
In this study describing TB testing in seven years of School of Medicine and School of Dental Medicine students at NYMC, we observed low rates of conversion to positive tests among students who matriculated into school with a negative TB screening test and even lower rates of conversion to a likely true positive test. These results suggest targeted testing for health profession students may be more appropriate than routine pre-clinical screening.