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