Tuberculosis in children in a national survey of notifications in England and Wales, 1978-79.Report from the medical research council tuberculosis and chest diseases unit

Abstract

A survey of all notifications of tuberculosis in England and Wales for a 6-month period has provided valuable information on childhood disease. Of the 479 children (aged less than 15 years) reported by the Office of Population Censuses and Surveys, 23% were receiving chemoprophylaxis, representing a major distortion in the published figures. Of the 353 children with newly notified, previously untreated disease, 50% were white and 38 % were of Indian subcontinent ethnic origin (Indian, Pakistani, or Bangladeshi). The estimated annual notification rate for 1978-79 for children was 7.0 per 100 000 population. The rates differed considerably between the different ethnic groups in England, the highest rates occurring in the Indian (90) and the Pakistani and Bangladeshi groups (130), and the lowest in the white group (3.6). A particularly important finding was that the notification rate per 100 000 for children of Indian ethnic origin born in the UK was 72 and for those of Pakistani or Bangladeshi ethnic origin was 95 compared with only 3.6 for white children. Of the children with respiratory disease about half had pulmonary lesions. Although most lesions were small, in 11% the total extent was greater than the area of the right upper lobe and 3% had obvious cavitation. Culture results were available for only 87 (3.6%) of the children with respiratory disease but 39% of these were positive; of the children with a positive culture, smear results were available for 29 of the children and 14 were positive. Although lymph node involvement was the most common non-respiratory lesion in both main ethnic groups, meningitis occurred in 24% of the white children with non-respiratory disease but in only 2% of the Indian subcontinent children.