ESTIMATION OF THE CONDITIONAL PROBABILITY OF TUBERCULOSIS GIVEN THE RESPONSE OF A MANTOUX TEST

For the planning of community tuberculosis, prophylaxis one must know the prevalence of tuberculosis (TB) infection as a function of response to the Mantoux intradermal tuberculin test; the standard test for indicating Mycobacterium TB infection. The skin induration size used to select individuals for prophylaxis must be chosen carefully, in view of the costs associated with carrying out and supervising such prophylaxis. The Mantoux test was used to obtain measurements on adolescents in metropolitan Victoria and on a small sample of adolescents with clinical TB. These data are employed to obtain estimates and to construct upper confidence bounds for the conditional probability of TB infection, given the level of Mantoux response. Two conservative methods are presented; one is ‘nonparametric’, the other ‘semiparametric’. The analyses indicate that for responses up to and including 13 mm, the probability of TB infection is less than.07 with ninety-five percent confidence.