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BOTH SCHOOLS
Total examined - 319 (Boys 165, Girls 154) less 9 in which
other contact was known 310
Total infected - 69 Less 5 in whioh other contact was known 64
Proportion of total infected 20.6%
SCHOOL "A"
Examined 125
Infected - 35 (Less 2 in which other contact was known) 33
Proportion of total infected 26.4%
CLASS AT RISK
(included in previous table)
*
Examined (total in class - 43) 26
Infected 6
Proportion of total infected 23.1%
SCHOOL "B"
Examined 185
Infected - 34. Less 3 in which other contact was known 31
Proportion of total infected 16.8%
(8) In considering these figures it should he remember that the
total numbers are small and that the Patch Test provides in practice
a quite useful index of skin sensitivity, but it is not one hundred
per cent accurate. I offer the following comments:-
(a) There would appear to be a significant difference in the
proportion of children infected in the two schools. School "B" does
however serve an area where the population is less dense and where
conditions of housing are generally better. This may partially
explain the difference. Taking the bread view of community risk of
infection, however, I feel that a few infectious cases, more or less,
in any one particular district of small size, may produce an
appreciable difference in the proportion of childhood infection, when
the numbers examined are comparatively few. Also School "A" was the
school "at risk", the particular risk factor probably being present
for some time. This p???int is certainly suggestive, but I would have
felt more happy about assessing its importance if the control school
had been of a similar character, serving an area where similar social
conditions obtained. Nevertheless the fact remains that the contact
schorl shows quite definitely a higher proportion of infection than
the control school. On the other hand the class in School "A"
subjected to the greatest degree of risk shows a slightly lower
proportion of infection than the school as a whole.
(b) Comparing the results with a large survey carried out at the
Brompton Hospital in 1931 (Lloyd, W.E. and Dow, Dorothy J. 1931,
British Medical Journal 2.183)., we find the following. In that
survey it was found that between the ages of 8 and 11 years, the
proportion of children infected was 40% at the lower age, rising to
50% at the higher. It is likely that the figures of our own recent
investigation would be lower for three reasons. Firstly, there has
been a steady fall, apart from the war years, in the death
notification figures for Tuberculosis, and in incidence figures.
There are indications that, as a result, the proportion of the
population infected in childhood and young adult life is now less
than it was some years age, the ''community pool" of infection being
smaller. Secondly, Lloyd and Dow were able to test"the children more
accurately by means of the Mantoux Intradermal Test. Thirdly, they
were dealing with children from very crowded London Boroughs, where
conditions are generally poorer than in Walthamstow, except in one
or two areas. I think one can, however, say that the proportion
found to be infected in our own survey does not indicate that
conditions here are any worse than they should be in present
circumstances. Our efforts are of course, directed toward the???e
eradication of the disease altogether, at which point we would find
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