Prevalence of pulmonary tuberculosis on the roof of the world
Abstract:SETTING: The Shimshal Valley, a remote village in Northern Pakistan, is one of the seven Pamirs of Central Asia, widely known as the roof of the world.
OBJECTIVE: To investigate the prevalence of pulmonary tuberculosis (TB) in the Shimshal Valley.
DESIGN: The Rapid Village Survey Method (RVS) was used to investigate the prevalence of pulmonary tuberculosis. The selection criteria were chronic cough, hemoptysis, past history of TB and close contact with a tuberculous patient. After clinical examination, a chest radiograph was done and a single spot sputum sample was obtained for smear examination.
RESULTS: The total population of the village was 1077, of whom 231 cases were studied. Overcrowding affected 75% of the study population. The prevalence of smear positive pulmonary TB in the village studied was 554 per 100000 population, and the prevalence of active smear-negative TB was estimated at 1949/100000. The prevalence of active pulmonary TB increased with age and the only risk factor for active TB was age over 45 years. Of the 21 cases with a past history of pulmonary TB, only 38% had completed a full course of chemotherapy.
CONCLUSION: Pulmonary TB is a very serious health issue in the rural community (Shimshal Valley) of Pakistan. This study highlights the lack of efficacy of national tuberculosis control programs in the country.
Document Type: Regular Paper
Affiliations: 1: Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan 2: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan 3: Department of Community Health Sciences, The Aga Khan University Hospital, Karachi, Pakistan 4: Department of Pathology, The Aga Khan University Hospital, Karachi, Pakistan 5: Department of Family Medicine, The Aga Khan University Hospital, Karachi, Pakistan
Publication date: November 1, 1998
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