SCOTTISH NATIONAL SURVEY OF TUBERCULOSIS NOTIFICATIONS 1993 WITH SPECIAL REFERENCE TO THE PREVALENCE OF HIV SEROPOSITIVITY

Background - The study sought to determine the contribution of HIV ser opositivity to the arrest of decline in tuberculosis notifications in Scotland. Methods - Survey forms relating to each tuberculosis notific ation in 1993 were completed by the notifying consultant. Voluntary an onymous HIV testing of tuberculosis cases aged under 65 was requested. Age, sex, ethnic status, country of birth, employment status, occupat ion, previous tuberculosis, contact status, risk factors for HIV infec tion, HIV serostatus of cases aged under 65, site, radiological extent , and bacteriological status of tuberculous disease were determined. R esults - Five hundred and seventy four cases of tuberculosis were orig inally notified, of which 77 (14%) subsequently proved to be non-tuber culous and were therefore denotified. Of the 497 cases 423 (85%) were white and 58 (12%) were from the Indian subcontinent. Eighty five per cent of patients from the Indian subcontinent were aged <55 years wher eas 64% of white patients were aged >55 years. Pulmonary disease was f ound in 74%, nonpulmonary in 22%, and combined disease in 4% of patien ts. Of 242 HIV tests performed, three were positive and five other HIV positive patients were known, giving an HIV positivity rate of 1.6% o f all tuberculosis notifications in 1993. Annual notification rates fo r Scotland were 9.7 per 10(5) before and 8.7 per 10(5) after exclusion of previously treated cases; rates were 8.4 per 10(5) for the white p opulation and 179 per 10(5) for those from the Indian subcontinent. Co nclusions - The study documents the distribution of tuberculous diseas e in Scotland by age, sex, site, and ethnic group for the first time. Notification practices, with respect to denotification, need to be imp roved. Infection with HIV is presently uncommon in cases of tuberculos is in Scotland but continued vigilance is essential.