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CHEST DISEASES AND TUBERCULOSIS IN A SLUM COMMUNITY
AND PROBLEMS IN ESTIMATING THEIR PREVALENCE |
AK Chakraborty, GD Gothi, Benjamin Issac, KR Rangaswamy,
MS Krishnamurthy & R Rajalakshmi: Indian J Public Health 1979,
23, 88-99.
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The entire population of a slum area of Bangalore
city, comprising of 3313 persons was registered, questioned for
symptoms and offered chest X-ray at a centre located in the slum
itself. Those, who had any chest symptom and/or X-ray abnormality,
were offered detailed examinations, viz., clinical examinations,
repeated examinations of sputum for tubercle bacilli, and further
chest X-rays. Of the total 2855 persons X-rayed and/or questioned,
1039 needed detailed examinations and about a fifth of the latter
required referral to a consultant panel for diagnosis of chest diseases.
Further, about 60% of those referred to consultants needed special
investigations. Thus, the study of prevalence of chest diseases
in the community needed considerable facilities and were operationally
difficult. It is envisaged that similar problems will also be faced
if peripheral dispensaries are to make proper diagnosis of chest
diseases, due to the need for referral of large number of patients
and provision of complicated diagnostic facilities at the referral
hospitals. The study seeks to quantify the problem of chest diseases
and tuberculosis in the slum community.
The prevalence of sickness in the population at
any point of time were 49.5%. Sickness related to the respiratory
system was 13.3%. It increased with age and was highest (42.6%)
in those aged 55 years and above. Among 2855 persons X-rayed, 145(5.1%)
had any radiological abnormality in chest. It is seen that respiratory
systems symptoms were commonest in all the age groups. A total of
172 patients were diagnosed to have respiratory system abnormalities
with or without X-ray lesions. Of them, 75% had non- tuberculous
etiology, 7.6% had active pulmonary tuberculosis and the remaining
17.4% had inactive tuberculosis. Prevalence of sputum positive cases
was 0.26% and prevalence of total active pulmonary tuberculosis
was 0.44%. The problem of arriving at final diagnosis was dependent
on application of complicated special investigation tools to a large
community. In view of the low coverage (47.4%) for the special investigations,
prevalence of different chest diseases in the community could not
be investigated.
It is concluded that in the community under study,
the size of the problem of non- tuberculous diseases of the chest
and operational problems in their diagnosis were considerable.
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KEY WORDS: PREVALENCE, URBAN, SLUM COMMUNITY,
CHEST DISEASES, CASE. |