EPIDEMIOLOGY <<Back
 
 
001
TUBERCULIN SENSITIVITY IN YOUNG CHILDREN (0-4 YEARS OLD) AS AN INDEX OF TUBERCULOSIS IN THE COMMUNITY.
NL Bordia, Anton Geser, J Maclary, I Mundt & Kul Bhushan: Indian J TB 1960, 8, 25-43.

The purpose of this study was to find out whether the prevalence of infection in young children might be used as an index of the tuberculosis problem in a population. Tuberculin testing was done in a random sample of 2,883 children (0-4 years) in Bangalore city, of those 2,589 (89.8%) actually completed testing. A total of 4340 children were registered in 59 villages and of these 4090 (94.2%) were tuberculin tested. The villages were from Bangalore, Kolar and Mandya as these districts were within 100 miles from Bangalore city. The team went from house to house and made a complete registration of the children 0-4 years in the selected houses. Information on socio-economic status, density of population etc., was also collected before giving tuberculin 1 TU RT 23 with Tween 80.

The results of the study showed that prevalence of infection in 0-4 years age group of cantonment area was 1.6% and in the crowded city area 4.1% at 14mm induration level. In the rural population, the prevalence of tuberculosis infection was 2%. In the city, a positive correlation between tuberculosis infection and socio-economic condition was obtained while it was not seen in rural areas. It was not possible to establish any correlation between tuberculosis disease and infection either in rural or urban areas, as the population was not examined for the prevalence of tuberculosis disease.

KEY WORDS: PREVALENCE, INFECTION, CHILDREN, RURAL, URBAN, COMMUNITY.

016
SOME EPIDEMIOLOGICAL ASPECTS OF TUBERCULOUS DISEASE AND INFECTION IN PAEDIATRIC AGE GROUP IN A RURAL COMMUNITY
GD Gothi, SS Nair & Pyare Lal: Indian Paediatrics 1971, 8, 186-94.

The prevalence and incidence rates of tuberculous infection and disease in the community are known in the age group 10 years and above from several surveys carried out so far. The present paper provides various parameters of tuberculosis in particular in the pediatric age group. A random sample of 119 villages in 3 taluks of Bangalore district were surveyed 4 times from May 1961 to July 1968 at intervals of 18 months, 3 years and 5 years of the initial survey. Tuberculin test was done for the entire available population with 1 TU PPD RT 23 with Tween 80, and 70mm X-ray for all available persons aged 5 years and above. Two samples of sputum were obtained from the X-ray abnormals, and examined by smear and culture.

It was found that prevalence of infection increased with age from 2.1% at 0-4 year age group to 16.5% at 10-14 year age group, compared to 47% at 15 years and above age group. Prevalence of disease in 5-14 year age group was considerably lower than in age group 15 years or more. Tuberculosis morbidity increased with the size of tuberculin reaction and it was high among children with reaction 20mm or more. Incidence of infection increased with age from 0.9% per year in age group 0-4 years to 2.8% per year among that of 15 years and above. Incidence of disease also showed the same phenomenon-, rising from 0.5% in age group 5-9 to 4% per year in the age group 15 years and above. There were 10 sputum positive cases in 5-14 years of age in first survey, of them, 8 became negative and one died. While from among 152 cases in 15 years and above age group, 48 became negative, 72 died and 32 remained positive. The fate of cases of pulmonary tuberculosis in 5-14 years age was not as serious as in 15 years and above age group. The survey had no means of examining miliary and meningeal tuberculosis.

Children as well as adults with larger reaction of 20mm or more to tuberculin test had higher mortality. This could be considered due to tuberculous infection after taking into account death due to non- tuberculous reasons in both the infected and uninfected groups. Use of chemoprophylaxis might be considered for those who give history of contact with open cases and have tuberculin reaction size 20mm or more.

KEYWORDS: CHILDREN, RURAL COMMUNITY, PREVALANCE, INCIDENCE, INFECTION, DISEASE, TUBERCULIN, INDURATION SIZE, MORTALITY, CHEMOPROPHYLAXIS.

031
TUBERCULOSIS IN CHILDREN IN A SLUM COMMUNITY
GD Gothi, Benjamin Isaac, AK Chakraborty, R Rajalakshmi & Sukant Singh: Indian J TB 1977, 24, 68-74.

A study was conducted in a slum area of Bangalore, to get information on the prevalence of all forms of tuberculosis in 0-4 year age group, respiratory tuberculosis in 5-14 year age group and the proportion of respiratory tuberculosis among total respiratory diseases in 0-14 year age group. Entire population in a slum area was investigated. Children aged 0-9 years were given tuberculin test and their nutritional status assessed. All persons were X-rayed. Sputum specimens were collected from those having radiological abnormality in chest, chest symptoms of one week or more in 0-4 years, in addition from those with any kind of sickness, malnutrition and tuberculin reactors.

In 0-9 year age group, 5.5% were tuberculin positive (without BCG lesions), in 0-4 years, 1.8% and 5-9 years, 11.3%. Among the X-rayed children, 47.4% had some kind of sickness, the proportion being significantly high in 0-4 year age group. The respiratory sickness is the commonest among children of all ages followed by malnutrition (21%). Among children with chest symptoms, upper respiratory infections were 33%. Chest X-ray abnormalities were present in 4.5% of children and of these 82.5% had non-specific pneumonitis. Of 71 persons with respiratory disease, about 7% were tuberculous. Out of 1408 children, only 5 had active primary tuberculosis, giving a prevalence of 0.35%. None in 0-4 year age had sputum positive disease or extra pulmonary tuberculosis.

It has been highlighted that non-tuberculous chest diseases are common in pediatric age group and many of these may be wrongly classified as active tuberculous in practice. It is concluded that tuberculosis in the pediatric age group in this community is not a serious public health problem.

KEY WORDS: CHILDREN, SLUM COMMUNITY, PREVALENCE, INFECTION, PEDIATRIC TUBERCULOSIS.

032
REPORT ON THE FIRST AND SECOND PASSIVE FOLLOW-UPS OF CHILD POPULATION IN 0-14 YEARS AGE GROUP IN A SLUM AREA OF BANGALORE
S Dwarakanath, Sukant Singh and R Rajalakshmi: NTI Newsletter 1977, 14, 97-104.

The findings of the two follow-ups conducted passively, in a slum area of Bangalore city, each at an interval of one year, are presented here. The objectives of the follow-ups were to study the migration, episodes of sickness and health status of sick people of initial survey over a period of time in the pediatric age group. The information was collected by two ways: (1) by visiting each house to collect information on sickness among them during the preceding year as per the questionnaire. (2) Going through the records of the Area Health Centre about various morbidities among the residents of the area pertaining to symptoms, diagnosis and treatment during any year noted.

Migration had occurred upto 7% in 0-9 year age group within first year and no migration during second year in 0-4 year age group. Out of 400 children belonging to 0-14 years, had symptoms related to respiratory system. In all, 5 children were diagnosed as case of active primary tuberculosis, non-e died in two years and one had persistent respiratory symptoms. Hospital records showed that only 1 out of 5 had attended any health facility with respiratory symptoms. The usefulness of passive follow-up without clinical investigations as a tool, needs to be reviewed. Most of the symptomatics do not go to hospital. Diagnosis cannot be arrived at by passive follow-up. It may be necessary to decrease the interval of follow-ups if it is desired to get precise idea on frequency of episodes of sickness, as most of the sicknesses are forgotten by the population with passage of time.

KEY WORDS: PASSIVE FOLLOW-UP, URBAN, SLUM COMMUNITY, CHILDREN, SICKNESS, MIGRATION.
 
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