026 |
INCIDENCE OF TUBERCULOSIS AMONG NEWLY INFECTED POPULATION
AND IN RELATION TO THE DURATION OF INFECTED STATUS |
VV Krishnamurthy, SS Nair, GD Gothi & AK Chakraborty:
Indian J TB 1976, 23, 3-7. |
Some of the parameters relating to duration of
infected status and incidence of disease have been measured by analysing
the data collected from the five year study. Between 1961-68, 119
villages in Bangalore district with total average population of
about 62,000 were surveyed at intervals of 1, 3 and 5 years from
the first survey. All persons were tuberculin tested with 1 TU RT
23 and those aged 5 years or more were X-rayed. Sputum of those
persons showing any X-ray abnormality were collected and examined
for AFB. Persons with X-ray abnormality but bacteriologically negative
or with normal X-ray in all the preceding surveys, and who became
culture positive with X-ray abnormality in the current survey were
termed as "New cases". New cases who had shown 10 mm or
more reaction to 1 TU RT 23 at I Survey were considered infected
previously. New cases, tuberculin negative at I survey but who showed
an increase of 16 mm or more between two consecutive surveys were
considered infected midway between the two surveys.
Of the 42 new cases diagnosed from among the newly
infected during 5 years, 81% came from those infected within one
year. Incidence rate of cases among those who were infected within
one year was about 5 times more than those infected earlier than
one year. Incidence of cases steadily decreased with the increase
in the duration of infection. Further, it was found that one fourth
of all newly diagnosed cases came from the newly infected persons.
However, the size of the pool of previously infected persons in
a community being much larger, at least 72% of the new cases came
from the reservoir of previously infected persons. The incidence
of disease among the newly infected was almost the same in the three
age groups i.e., 5-14, 15-34 and 35 years or more. But, the ratio
of the incidence rates for the newly infected and the previously
infected decreased from 13 for the age group 5-14 to 3 for the age
group 35 years and above. In other words, the incidence of disease
among the newly infected in the age group 5-14 was thirteen times
more than for the previously infected in the same age-group whereas
in the age-group 35 years and above, the incidence among newly infected
was only thrice that among the previously infected.
Out of the 160 new cases diagnosed during the three repeat surveys,
21 per cent cases came from among those who were infected on the
average for one year or less. This is almost in conformity with
the hypothesis that one-fourth of all new active cases come from
new infections less than a year old.
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KEY WORDS: INCIDENCE, INFECTION, CASE, TUBERCULIN
STATUS. |