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Free Content Childhood tuberculosis: an index measuring the ability to detect cases early

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Setting: Tuberculosis control programmes are conventionally monitored using data from sputum smear positive adult patients. Good overall results may mask significant and avoidable shortcomings with tuberculosis control in children.

Objective: To develop a specific surveillance tool for child patients, using the ability to detect cases early as a parameter for the impact of control measures.

Design: A simple index of early detection was compiled with values ranging from 0 to 100. Three groups of tuberculous children diagnosed in Germany between 1985 and 1994 (n = 303), and five other groups from the literature, were used to make a preliminary assessment of the validity of the index.

Results: The index values of 10, 13 and 24 for the German groups correlate well with other analysed patient data and the different functions of the institutions where the patients were diagnosed. Comparable characteristics could be found when applying the index to published data of other cases, with values of between 12 and 74.

Conclusion: The proposed index seems suitable for monitoring early detection of child cases. Unexpected trends can be disclosed or effects of changed programme activities assessed. Routine use of the index would help the health services focus their attention on problem areas and specific patient groups with extremely low or falling index values. Conclusions can be drawn regarding the overall impact of the control programme.
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Keywords: children; detection; index; monitoring; tuberculosis

Document Type: Regular Paper

Affiliations: 1: University Children's Hospital, Heidelberg, Germany 2: Division of Paediatric Pneumology and Immunology, Children's Hospital of the Humboldt University, Berlin, Germany 3: Public Health Office, Heidelberg, Germany

Publication date: 1998-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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