In planning secondary prevention for a community clinic serving mainly migrant families, which activity should be a priority?

• A. Skin testing for TB
• B. Immunization screening for children
• C. Blood pressure screening for adults
• D. Diabetes screening via HbA1c for adults

Answer: (A)

Screening to find disease before symptoms appear is secondary prevention. In a clinic serving mainly migrant families, the priority is to identify latent TB infection early to prevent progression to active TB and to reduce transmission in the community. A skin test for TB (Mantoux) is a practical, cost-effective screening tool that can be done in a community setting. A positive reaction indicates TB infection, which then prompts further evaluation with chest imaging and possible sputum testing to rule out active disease. If active TB is not present, treatment of latent TB infection decreases the chance that it will become active, protecting both the patient and others they might contact.

Immunization status checks and screenings for blood pressure or HbA1c are important parts of care, but they align more with primary prevention or chronic disease risk assessment rather than identifying an infectious disease early to halt transmission.