結核まん延度の指標としての学校生徒の肺石灰化巣
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概要
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A study has been made to obtain the indices which are useful to select the high prevalent areas of tuberculosis, on the basis of routinely available informations from the mass X-ray and tuberculin surveys of school pupils aged 6-14 years in Kawasaki City. Rate of markedly (redness over 10mm with induration and duplicate redness) and moderately (redness over 10mm with induration) positive reactors to Mantoux test (2.5 TU PPDs) among 1st grade pupils of primary school (6 years of age), and appearance rate of calcified pulmonary and/or hilar nodes primary foci on mass miniature radiography among all pupils of primary and/or junior high schools in the City, were drawn from the results of survey in 1971, and calculated for each city wards. Simultaneously, annual incidence rate of newly notified active tuberculosis (all forms) and infectious pulmonary tuberculosis, prevalence rate of registered tuberculosis (including inactive case, all forms), active tuberculosis (all forms) and infectious pulmonary tuberculosis at the end of the year, were drawn from the registry of tuberculosis of 1971 in Kawasaki City and calculated for each city wards.<BR>Analyses were made to determine the relation between each rates of the former and those of the latter respectively. Rate of moderately positive reactors to Mantoux test among 1st grade pupils of primary school and appearance rate of calcified foci among all pupils of primary and junior high schools in each city ward directly correlated with prevalence rate of infectious pulmonary tuberculosis in each city ward respectively. Moreover, appearance rate of calcified foci among pupils of junior high school in each city ward directly correlated with annual incidence rate of infectious pulmouary tuberculosis in each city ward.<BR>BCG vaccination during infantile and preschool periods has been applied in the City on a mass scale. Therefore, the rate of moderately positive reactors among 1st grade pupils of primary school was regarded to be of little value as an index of prevalence of tuberculosis.<BR>In order to determine further relation between appearance rate of calcified foci among pupils and annual rates on registry of the City, records of school survey and registration data in 1962, 1965, 1968 and 1971 were analysed. Appearance rate of calcified foci among pupils of junior high school in every 3years directly correlated with annual incidence rate of newly notified active tuberculosis (all forms) and infectious pulmonary tuberculosis, and prevalence rate of registered tuberculosis (all forms) respectively, but not correlated with prevalence rate of infectious pulmonary tuberculosis. The discrepancy may be derived from the alteration of criteria on “infectious”.<BR>It was suggested that the prevalence of calcified foci found in school pupils may be of value as an index of prevalence of tuberculosis in the area.
- 日本結核病学会の論文