CLINICAL MANIFESTATIONS AND EPIDEMIOLOGY OF CHILDHOOD TUBERCULOSIS INSTOCKHOLM 1976-95

81 cases of tuberculosis infection (17) and disease (64), seen between 1977 and 1995 at St Goran's Children's hospital, Stockholm, Sweden ar e reviewed. The incidence of tuberculosis disease increased from 1 to 6/10(5) children/y. The increase was due to immigration from high-prev alence countries, with an incidence of 20/10(5) in a partly segregated suburb, Most of the children were foreign-born. Of the 31 0-4-y-old c ases, 19 were born in Sweden, and 7 had received BCG vaccination. For Swedish-born children with Swedish-born parents, the incidence of tube rculosis disease remained stable at < 0.5, 50 patients were symptomati c when first seen (60% pulmonary tuberculosis, 8% miliary tuberculosis , 25%, cervical adenitis, 15% other extrapulmonary. tuberculosis). The re was 1 death, and in 2 children complicated tuberculosis courses. Si de effects of drug therapy were seen in 5% of the children. In conclus ion, tuberculosis remains an important differential diagnosis in child ren of immigrants from high-prevalence countries for at least 5 y afte r settlement in Sweden, The practice of delaying BCG vaccination of th em until 6 months of age can be disputed.