|PREVALENCE OF TUBERCULOSIS IN A RURAL AREA BY AN
ALTERNATIVE SURVEY METHOD WITHOUT PRIOR RADIOGRAPHIC SCREENING OF
|AK Chakraborty, HV Suryanarayana, VV Krishna Murthy,
MS Krishna Murthy & AN Shashidhara: Tubercle & Lung Dis
1995, 76, 20-24.
Mass miniature radiography (MMR) is the usual tool
for population screening in tuberculosis case prevalence surveys.
However, this facility is not available at most centres in India.
An attempt was made to study the feasibility of carrying out sputum
positive case prevalence survey in a population by introducing methodological
variation in the screening, in order to select those eligible for
sputum test without resorting to the customary use of MMR for the
purpose. The study was carried out in Bangalore rural district during
1984-1986. The area was the same as for six earlier prevalence surveys
conducted since 1961. The population aged up to 44 years was tuberculin
tested. Persons with test induration size of = 10 mm were eligible
for sputum examination, besides all those aged over 45 years were
eligible. It was observed that 78.4% of the registered population
(29400) in the age group 10 years and above were required to undergo
sputum examination by the present method of screening leading to
a very high work load of sputum examination necessitating deployment
of additional sputum cultures. Thus, the purpose of pre selection
for sputum examination was hardly fulfilled. Further, a high contamination
rate was observed. The changed screening procedure in this survey
made comparison with the earlier data difficult.
The overall prevalence rate of cases was 438/100,000
in persons aged 10 years and above, while smear positive prevalence
rate was 68/100,000. The observed prevalence rate was similar to
earlier surveys, while smear positive prevalence rate was much lower.
In conclusion, the screening methodology was found to be operationally
unfeasible, ineffective and counterproductive to complicate the
survey procedure in the quest for simplicity.
|KEY WORDS: SURVEY, SCREENING PROCEDURE, SYMPTOMS.