Pulmonary tuberculosis in a rural school and community a follow-up study

Abstract

Summary The results of the routine investigation of a case of tuberculous meningitis are reviewed. This paper is concerned with the five-year follow-up of the original cases and contacts, both adult and of school age. By April 1949 seventeen other cases of tuberculosis had been discovered. The negative reactors contributed one case of active primary tuberculosis before April 30th of that year. Three of those that had conversion of tuberculin tests did so within six months of the original survey—all were contacts. By January 1954 the total number of new cases discovered had risen to twenty-seven, including three children who then showed hilar calcification without previously having exhibited a pulmonary lesion. Later the original school group of cases contributed one reinfection type of moderately advanced pulmonary tuberculosis. Home contact investigation and follow-up yielded two previously unknown cases of post-primary infection pulmonary tuberculosis, one further active primary infection and one which went on from an effusion resolved to minimal active disease. In five years twenty-nine other children came into the school. Although seven showed positive tuberculin patch tests when examined in school six of these were contacts with previous positive patch results. The seventh child developed a positive test while in school and X-ray examination revealed an active primary infection. The need for detailed investigation and routine follow-up of every case and contact of pulmonary tuberculosis is demonstrated.