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James Bayuk, MD
US Embassy Cairo, Egypt

JAMA. 1995;274(24):1912-1913.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The study of tuberculosis (TB) screening of schoolchildren by Dr Mohle-Boetani and colleagues¹ highlights targeted screening of non—US-born children as a cost-effective mechanism to detect and treat TB infection. In the accompanying Editorial, Dr Starke² reinforces this finding with multiple studies that document the high tuberculin skin test reactivity in non—US-born children. Both articles are compassionate and realistic in their concern about stigmatization of the target groups as an impediment to effective public health programs.

Stigmatization occurs because a new population—immigrants attempting to blend into the resident population of the United States—is identified with a negative attribute, TB infection. Targeting part of an already blended population guarantees stigma. Unfortunately, a school examination is commonly the first time a new immigrant child is evaluated for TB. This situation is complicated by our current immigration medical screening system, which has no functioning mechanism to test anyone younger . . . [Full Text PDF of this Article]

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