View report page

72
in keeping registers, and especially in tabulating
statistics for the Ministry of Health.
Tuberculosis in Children.
A large number of children attend the Dispensary
clinics, many of whom are contacts. Very few cases
indeed are found to have a clinically recognisable
tuberculosis of the lungs, and those with a positive
sputum result are rare. (Possibly the fact that
children almost invariably swallow their secretions
instead of coughing them out may account to some
extent for the latter fact: and it has very occasionally
been found that an examination of the faeces or a
"stomach wash" may reveal the tubercle bacillus).
The large majority of children become infected
at some period with the organism: but this "tubercularization"
gives rise to very few symptoms and
practically no actual disability, unless perhaps when
"massive" doses are acquired during early infancy
—the factor which, no doubt, causes the high peak
of infantile mortality (due to tuberculosis) before
resistance is acquired.
Many doubtful cases of lung, gland or abdominal
type are referred during the course of the year to the
Dispensary; and it is now the practice to do
"Mantoux" Tuberculin tests on as many children
as possible, up to the age of sixteen.
This test is sufficiently reliable to establish an
evidence of "infection" with Tubercle Bacilli when
carried out systematically, there being only a small
percentage of error: and in a few doubtful cases,
where the diagnosis may be "almost certain" clinically,
the specific reaction is sufficient to clinch the matter
and enable the Tuberculosis Officer to get the child
away. The consent of parents or guardians is always
obtained,