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Free Content Trend in the annual risk of tuberculous infection in Egypt, 1950 –1996

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OBJECTIVE: To determine the trend in the risk of tuberculous infection in non-BCG vaccinated children in Egypt in the period 1950–1996.

METHODS: In 1949–1952, a tuberculin survey was carried out in Egypt by the World Health Organization (WHO) covering 103 districts. In 1995–1997 a tuberculin survey was carried in 73620 primary school children in grade one in the same districts, using international guidelines. The trend in tuberculous infection was determined by comparing the prevalence of Mantoux reactions of ≥6 mm in the two surveys in subjects without apparent BCG scar aged 6–7 years. For an estimate of current risk of infection the 17 mm cut-off point (number with 17 mm plus twice the number with greater than 17 mm) was used.

RESULTS: In 1995–1997, 76% of children had a BCG scar. Infection prevalence estimates in 14766 non-BCG-vaccinated children with a mean age of 6.7 years were 11.9%, 4.1%, and 2.1% for the cut-off points 6 mm, 10 mm, and 17 mm, respectively. Decline in the risk of infection was estimated to be in the order of 50% over 45 years, or 1.5% per year. The geometric mean annual risk of infection in the 6.7 years before the survey was estimated at 0.32% (95% confidence interval 0.27–0.40%). For Egypt, the incidence of smear-positive tuberculosis was estimated at 16 per 100000 population, giving a case detection rate of 85% (range 56 –100%).

CONCLUSION: This survey has shown that the size of the tuberculosis problem in Egypt is considerably smaller now than it was 45 years ago.

Keywords: Egypt; annual risk; infection; tuberculin survey; tuberculosis

Document Type: Regular Paper

Affiliations: 1: National Tuberculosis Control Programme, Ministry of Health and Population, Arab Republic of Egypt 2: Royal Tropical Institute, Amsterdam, The Netherlands 3: Royal Netherlands Tuberculosis Association, The Hague, The Netherlands 4: Royal Tropical Institute, Amsterdam, The Netherlands; and International Tuberculosis Surveillance Centre, The Hague, The Netherlands

Publication date: April 1, 1999

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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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