View report page

TUBERCULOSIS IN CHIIDHOOD. The number of children in whom active tuberculosis is
found remains comparatively small but has shown no marked trend of recent years. The
number of children found to be suffering from tuberculosis was 14 in 1952 and the same
number was found in 1953; while in 1954 and this year the number was 13 in each year.
A summary of the work of the West Ham Chest Clinic in this respect has kindly been
contributed by Dr„D,J.Lawless, the Consultant Chest Physician;-
Number of school children referred by assistant school medical officers 1
Number of school children referred by general practitioners 96
Number of school children examined as contacts l8l
Number of school children found to be suffering from tuberculosis 13
The classification and disposal of the definite cases is set out below:-
Resplrat-ory Npn-respiratory
Active primary pulmonary tuberculosis 8 Symphysis pubis 1
Primary tuberculous pleural effusion 1 Peritonitis 1
Post primary active pulmonary Cervical glands 1
tuberculosis 1
These 10 respiratory and 3 non-respiratory cases were admitted to hospital.
B.G.G.YACCINATION. In September 1950, the Medical Research Council began a controlled
clinical trial with school leavers. The main object of the research was "to determine with
precision tuberculosis mortality arising in each of the groups of the trial in the years
following their first examination for the trial." West Ham children in their final year at
secondary modern schools and nearly all of whom were aged between l4i and 15 years, took
part in this investigation, and the procedure was described in some detail in my report
for the year 1953. All children taking part in the trials, both positive and negative
reactors to the intracutaneous skin test, are being followed up for some years, and are
being offered an annual x-ray examination and a repeat tuberculin test. The Medical
Research Council Team visited West Ham in June 195^ for the second annual x-ray and tests
of the school leavers (Christmas 1951 and Easter and Summer 1952), and again in February
and October 1955 for the third annual x-ray and tests of the school leavers (Easter,
Summer and Christmas I95I and Easter and Summer 1952) Approximately 1,300 home visits
were made by the school nurses during 1955.
So far, a satisfactory proportion of the boys and girls have remained in the trials
and much of the credit for this is due to the keenness and good work of the health visitors
and school nurses who visit the children once a year in an attempt to sustain their interest
and to enquire about their health at the time of the visit and during the previous interval.
This work, which has often involved making repeated visits, has been painstakingly carried
out, and the interest of the volunteers and their parents in the trial and their response to
the invitation for x-ray, are a reflection of the effort made. The trial is still in
progress and the first progress report presenting preliminary results after each participant
had been in the trial for two and a half years, with supplementary Incomplete information
up to four years, was issued in the early part of 1956. The results can be said to be most
encouraging, and the investigation has provided evidence of the efficiency of B.C.G. in
preventing tuberculosis in adolescents. It is hoped to give in next year's report a resume
of the progress.
132