An epidemiological survey of mycobacterial disease in New South Wales, 1965-1969.

Abstract

Three hundred and eighty deaths were registered over the five-year period of review as being due to mycobacterial disease; the rate per 100,000 of population in males fell from 3·5 in 1965 to 1·5 in 1969, and that in females varied between 0·77 and 1·07. Seven deaths occurred under the age of 10 years, all In females; four had been born outside Australia. The prevalence was estimated, from a questionnaire survey carried out on a sample of households, as 96 per 100,000 of population in 1968. The incidence of newly-discovered active disease was assessed from notifications of 4,203 cases, made up of 3,758 of pulmonary infection and 445 of non-pulmonary infection; 2,976 of the patients were males and 1,227 were females, and 3,053 were Australian-born and 1,150 had been born overseas. More than one-third of the pulmonary cases were discovered by mass radiographic survey. The rate of notification of pulmonary cases fell annually from 21·4 to 13·0 per 100,000 of population, from 1965 to 1969; the age-specific rate, with age advancing to 80 years, rose in males to over 100 per 100,000, but In females it did not exceed 25. The severity of the infection in the pulmonary cases was moderate in 61%, minimal in 25% and advanced in 11%; 3% of the patients presented with a pleural effusion. Ninety-three per cent of those for whom the result of the test was available (73%) reacted to tuberculin. In 13% of the non-pulmonary cases the disease was accompanied by active pulmonary tuberculosis, and in 11% by Inactive pulmonary tuberculosis. Under the age of ten years, lymph-node disease was the commonest type of non-pulmonary disease; in adults, the commonest type was genito-urinary disease, occurring 5·4 times more frequently In persons born abroad than in native-born Australians. Bacteriological testing was carried out in almost every case of pulmonary disease, but was not reported in over 6% of non-pulmonary cases. Four hundred and thirty-three strains isolated from pulmonary disease were typed; of these, 45 were those of anonymous organisms. Of the latter, 18 were regarded as being of pathogenic significance in the particular case.