[Epidemiology of tuberculosis in Switzerland]

Mortality for tuberculosis declined from an average of 7.5% per year in 1952 to 1.7 in 1988, tuberculosis incidence declined by 5 to 6% per year since 1945 to 17.4% in 1988, and the annual risk of infection declined by 11.4% per year since 1945 to 10.9 per 100,000 inhabitants respectively. The crude prevalence of tuberculous infection in the Swiss population is estimated to be 22.3% for the year 1990. The age-specific prevalence of infection is mirrored in age-specific morbidity. Among Swiss citizens, tuberculosis has become a disease of the elderly and is on the brink of elimination. In contrast, tuberculosis among foreigners (40% of cases in 1988) occurs mainly among the young who experience a more than 10-fold elevated risk compared to their Swiss age peers. These data suggest that case-finding and contact investigations are the major intervention tools against tuberculosis in the Swiss population. The increased tuberculosis risk among foreigners and the young age of these patients suggest that identification of those at high risk and their preventive treatment will have to be pursued actively.