RISK OF INFECTION WITH MYCOBACTERIUM-TUBERCULOSIS AMONG CHILDREN AND MOTHERS IN SOMALIA

The prevalence of infection with Mycobacterium tuberculosis in prewar Somalia was surveyed by testing the tuberculin sensitivity of 2,792 in fants and children and 446 mothers in two towns: Burao in the dry nort h and Kismayo in the humid south. Sensitivity increased with age, but considerable differences prevailed between the towns. In Burao a rough ly linear increase in sensitivity was found, with no sensitivity in in fancy, sensitivity in 19% of children at 7 years, and sensitivity in 5 4% of children at 15 years; in Kismayo the corresponding figures were 9%, 28%, and 47%, respectively. Together, the correlation of prior BCG vaccination with a positive tuberculin test in Burao and the lack of these findings in Kismayo suggested that vaccination had partly failed in Kismayo, where living conditions also favored the transmission of M. tuberculosis. The annual risk of M. tuberculosis infection was simi lar to 1% higher in the south than in the north and was much higher du ring the first 3 years of life than later. This study-the first defini ng the risk of M. tuberculosis infection among children of various age s in Somalia-indicates that this risk is greatest in the southern part s of the country and among infants and young children.