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66
The investigation only covered patients newly notified
or transferring into the borough from other areas. The total
of three hundred and forty-two cases surveyed differs from the
total of tuberculous patients visited in the year in so far as
the difference consisted of old cases changing residence within
the borough.
In 1951, a full survey was not made, but it was estimated
that 20% of the tuberculous patients visited for the first
time in that year were immigrants who contracted the disease
within ten years of arrival in this country. A more accurate
investigation showed that the proportion for 1952 was 16%,
whilst the comparable figures for 1953 and 1954 were 10% and
16% respectively. Persons born in the Republic of Ireland
were regarded as immigrants for this purpose.
The 1951 Census figures showed that out of a total
population of 168,160, there were 29,353 residents (or just
over 17%) who were born outside the United Kingdom and the
Republic of Ireland.
Tuberculosis - Notifications and Mortality, 1913-1954
Although tuberculosis has been notifiable in one form or
another throughout this century, the present system was not
established until 1912, and statistics comparable for one year
with another are available from 1913. The graph on Page 67
shows notifications and deaths in Kensington for this disease
since 1913 with a distinction between pulmonary and nonpulmonary
tuberculosis.
The trend of notifications for both types of the disease
follows the same pattern. At the beginning of the period, the
number of notifications fell rapidly to a certain level and then
followed a fairly regular course. There were, however, two
exceptional periods in which this pattern was disturbed. They
occurred during and after the two World Wars when the number of
notifications tended to rise. This tendency was less marked
in non-pulmonary tuberculosis during and after the Second World
War, but this was due to the relatively small numbers involved.
So far as pulmonary tuberculosis is concerned, the disturbed
pattern has not yet settled down to what might be assumed to be
a long term downward movement. In part this is due to the war,
but the comparatively high number of notifications might also be
explained as a result of the intensive effort made in recent
years to achieve early recognition of the disease by mass-radiograph
The decline in mortality shows a contrast to that of
notification. There was no abrupt fall at the beginning of the
period, but on the other hand the decline has continued steadily.
In general terms, it may be said that tuberculosis mortality has
followed the general trend of mortality, probably for the same
reasons. In addition, however, there are more specific factors
to which credit should be given.
As far as pulmonary tuberculosis is concerned, mention has
already been made to early diagnosis. In both the curative and
preventive aspects of the disease, early diagnosis plays an
important role. It undoubtedly saves the lives of many who would
otherwise have died following a diagnosis in the later stages of
the disease.
In addition, methods of treating the disease over the period
have been much improved. In non-pulmonary tuberculosis, the
treatment of tuberculous meningitis with streptomycin and its
derivatives has contributed markedly to the diminution of deaths
from this particular type of disease, especially in children. In
short, the graph shows that people who, fifty years ago, would have
died from tuberculosis are now dying from other diseases. Furthermore,
as indicated by the statistics shown on Page 8 of the Report)
the incidence of mortality has shifted to the older age groups.