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[Model of eradication of tuberculosis in children in an area with high epidemiological potential]
Insights
A 1972 tuberculosis prevention program in children using tuberculin testing and BCG vaccination significantly reduced new cases and eliminated severe forms of the disease. This initiative demonstrated a substantial decrease in tuberculosis incidence and mortality among children.
Area of Science:
- Public Health
- Pediatric Medicine
- Epidemiology
Context:
- Tuberculosis (TB) remains a significant global health challenge, particularly in pediatric populations.
- Early detection and prevention strategies are crucial for controlling TB transmission and reducing disease burden.
- The Drajna dispensary in Prahova County implemented a comprehensive TB control initiative in 1972.
Purpose:
- To evaluate the effectiveness of a combined approach of tuberculin testing and BCG vaccination in preventing and eliminating childhood tuberculosis.
- To assess the impact of mass screening and vaccination campaigns on TB incidence and severity in children.
- To determine the feasibility of scaling up successful interventions county-wide.
Summary:
- Over 31,000 children aged 1-14 were screened using PPD-IC65 tuberculin, with 12.6% showing positive reactions.
- 22,779 children were vaccinated with the BCG (Pasteur-Paris strain).
- Radiological screening of reactors identified 24 new asymptomatic TB cases, indicating an efficiency of 0.8/1000 children tested.
Impact:
- The intervention led to a 5-fold reduction in TB indicators by 1973, with severe forms and deaths disappearing.
- BCG-vaccinated children showed a reduced annual risk of developing TB (4.4/100,000).
- Extending these measures county-wide is projected to rapidly improve pediatric TB epidemiometric indicators.
Abstract:
In the territory of the Drajna TB dispensary, in the Prahova County, a series of complex measures have been experimented in the course of the second trimester of 1972, intending to prevent and to eliminate tuberculosis in children. Of the 31,731 children aged between 1 and 14 years, 29,496 have been tested with 2 units of PPD-IC65 (93 percent). A proportion of 12,6 percent of those tested presented reactions of more than 10 mm in diameter and 22,779 were vaccinated with BCG (Pasteur-Paris strain). The radiological pulmonary control of the reactors allowed for the detection of 24 cases of tuberculosis all of them new and asymptomatic. The efficiency of the detection was of 0,8 new cases per 1,000 tuberculin tested children or of 0,4 new cases per 100 of reactors that had been x-ray examined. This prophylactic action was repeated in 1973 in 2,219 children aged between 1 and 2-1/2 years that had been ommited in the preceding year and 4 new cases of tuberculosis were detected. In the medical districts in which there was a high prevalence of the children infection total radiophotographic case finding of the adult population was carried out. The result was a doubling of the TB incidence in children in 1972 followed by a 5-fold reduction of the indicators in 1973. The severe forms and death through tuberculosis in children have disappeared. The risk to develop the disease in BCG vaccinated children was reduced to 4,4 0/0000 per year. It is estimated that a generalization over the whole of the county of these prophylactic measures, as applied in the Drajna territory, under the form of a mass campaign, will allow for an improvement of the epidemiometric indicators in children in a relatively short time.