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RATIONALE AND OBJECTIVES: Identifying and treating persons with latent tuberculosis (TB) infection (LTBI) at high risk for developing TB is part of the current TB elimination strategy. There are no specific criteria, other than medical risks, to designate groups as high risk for developing TB. We hypothesized that, if location-based screenings were done in communities where persons with genotypically clustered Mycobacterium tuberculosis resided, then persons with LTBI from recent transmission and with undiagnosed TB could be identified. METHODS: Location-based TB screenings were done in partnership with multiple community-based organizations using resources previously used for other types of screening. MAIN RESULTS: Location-based screenings identified one person with TB for every 83 screened, and one person with LTBI for every five screened. The yield of this targeted screening program for discovering persons with TB and LTBI exceeded what would be expected from nontargeted screening in a county with a TB incidence of 5.7 per 100,000 population. CONCLUSIONS: Genotyping combined with geographic information systems analysis can potentially be used to define high-risk status and to define areas for location-based TB screenings. [ABSTRACT FROM AUTHOR]

Setting: Urban county health department in Tarrant County, Texas, USA., Objective: To determine the yield of associate investigations in non-bacille Calmette-Guerin (BCG) immunized children with positive tuberculin skin tests (TSTs)., Design: We compared the results of associate investigations of the contacts of 38 TST-positive, non-BCG-immunized pre-school children with the results of contact investigations of 290 culture-confirmed persons with tuberculosis (TB)., Results: Associate investigations were more likely than contact investigations to identify persons with culture-confirmed TB and positive TSTs. Contacts identified through associate investigation of non-BCG-immunized pre-school children were 9.4 (95%CI 4.2-22.5) times more likely to have culture-confirmed TB and 2.3 (95%CI 2.0-2.7) times more likely to have positive TSTs than contacts of persons with culture-confirmed TB., Conclusion: While conducting associate investigations is labor intensive, these data indicate that associate investigation of pre-school non-BCG-immunized children should be assigned priority in TB control activities, at least equal to the importance of investigating the contacts of culture-proven TB.