A baseline survey of the prevalence of tuberculosis in a community in south India at the commencement of a DOTS programme

P G Gopi, R Subramani, S Radhakrishna, C Kolappan, K Sadacharam, T S Devi, T R Frieden, P R Narayanan
International Journal of Tuberculosis and Lung Disease 2003, 7 (12): 1154-62

OBJECTIVE: To determine the baseline prevalence of culture-positive and smear-positive tuberculosis and the annual risk of tuberculous infection (ARTI) in a community in south India where DOTS is being implemented.

METHODS: Using cluster sampling, 50 rural panchayats (villages) and three urban units in Tiruvallur district were selected randomly. All adults aged > or = 15 years underwent symptom and radiographic examination, and those with abnormal shadows and/or chest symptoms had sputum smear and culture examination. In another cluster sample of 73 villages and three urban units, all children aged < 10 years were tuberculin tested.

RESULTS: The prevalence of culture-positive and smear-positive tuberculosis was respectively 605 and 323/100,000. Both increased appreciably with age, and were substantially higher in males than in females at all ages; the overall male:female ratio was 5.5 for culture-positive and 6.5 for smear-positive tuberculosis. The ARTI in children aged under 10 years was 1.6%, and was unaffected by sex. Over three decades there was an overall decline of 1.8% per annum in the prevalence of culture-positive and 2.1% for smear-positive tuberculosis.

CONCLUSION: Tuberculosis is a major problem in this rural community in south India, with a prevalence of 605/100,000 for culture-positive tuberculosis and 323/100,000 for smear-positive tuberculosis.

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