002 |
SIZE & EXTENT OF TB PROBLEM IN URBAN & RURAL
INDIA |
Raj Narain: Indian J TB 1962, 9, 147-50 & also
in Proceed Natl TB & Chest Dis Workers Conf 1962, 155-68. |
The aim of modern Public Health Programmes, is
a reduction in the total amount of disease in the community. The
unit for treatment and cure is not an individual but a sick community.
With this new aim, it becomes essential to know the size and extent
of tuberculosis in the community as it will be helpful not for purposes
of planning only but essentially for the assessment of their effect
on the problem. An attempt is made to review the important features
of the available knowledge about infection, morbidity and mortality
through various surveys. (i) Prevalence of Infection: Tuberculosis
infection is widespread in both urban and rural areas of almost
all parts of the country. Nearly 40% of the population are infected.
To avoid the effect of non- specific allergy and get a more reliable
demarcation, tuberculin reactions of 14mm and more were considered
as positive by National Tuberculosis Institute. (ii) Prevalence
of morbidity: The prevalence of radiologically active tuberculosis
in the population is likely to be 1.5%, Prevalence of bacteriologically
confirmed diseases is 0.4%. Based on single sample of sputum examination,
the prevalence of infectious cases in the country is probably an
under estimate. About two million are infectious at any one point
of time. (iii) Mortality: Deaths from tuberculosis in the
country is not definitely known. The impression of clinicians that
death due to tuberculosis have fallen sharply may not be true. Half
a million deaths will appear an underestimate. About 250 per 1,00,000
persons i.e., one million deaths due to tuberculosis per year seems
to be a reasonable estimate. (iv) Bovine Tuberculosis: Only
a few cases in man caused by the bovine tubercle bacillus have been
reported although 2.75% to 25% of cattle have been found tuberculin
reactors.
To put in a nut shell, the problem of tuberculosis
in India is a gigantic one and our means of fighting it with the
single tool of BCG, do not even touch the fringe of the problem.
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KEY WORDS: INFECTION, SUSPECT CASE, CASE, MORTALITY,
COMMUNITY. |