Prevention of tuberculosis in infancy

A prospective study was conducted on 185 consecutive hospitalized cases of tuberculosis below the age of one year, and 41 mothers comprised half of the 83 contacts detected. Maternal and infant infection was analyzed to determine whether the disease could have been prevented under the existing medico-socio-economic conditions. Most mothers had delayed diagnosis and extensive disease. Earlier imperfect courses of chemotherapy were not uncommon. Ten mothers were sputum-positive for acid-fast bacilli. The concerned medical personnel failed to give proper advice with respect to chemoprophylaxis and surveillance of infants. Majority of infants had progressive pulmonary and disseminated disease although, 41% of them were BCG vaccinated. A practical strategy in the Indian context for the management of tuberculosis in the mother-infant pair is outlined.