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