THE TREATMENT OF PRIMARY TUBERCULOSIS IN CHILDHOOD

Abstract

A preliminary inquiry of the Institut National d'Hygiéne (France), based on the follow-up of 5,526 cases of primary tuberculosis in children and adolescents, is reported; 1,425 cases were seen before 1955 and included in the statistical survey concluded in June, 1956. The spontaneous course of 895 patients who received no treatment is analyzed; special emphasis is placed on complications and their relative incidence in the different age groups and forms of primary tuberculosis. Comparative studies of treated and untreated cases were possible only in patients under 15 years of age and in clinically manifest forms of tuberculosis (Types II, III, and IV). These cases represent a total of 1,061 cases; 564 patients received treatment, 497 received no treatment. Findings in the different age groups are analyzed. A bacteriologic inquiry was also made on the problem of contamination with streptomycin- and isoniazid-resistant strains of M. tuberculosis and on secondarily acquired resistance to isoniazid in treated patients. A decrease of more than 80% in the incidence of complications led to the conclusion that routine chemotherapy should be resorted to in clinically manifest primary tuberculosis in children and adolescents. In the case of completely latent primary tuberculosis, however, a definite answer cannot be given as yet. It is the purpose of the future development of the trial to try to answer that question.