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.

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.