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Free Content Prevalence of pulmonary tuberculosis on the roof of the world

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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.
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Keywords: prevalence; rapid village survey; tuberculosis

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: 1998-11-01

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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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