Childhood tuberculosis in an urban population in South Africa: burden and risk factor

Aim-To study the epidemiology of childhood tuberculosis (TB) in a developin g country. Setting-Two urban communities of Cape Town, South Africa with a TB case not ification rate of 1149/100 000. Design-Retrospective descriptive study using the national population census (1991), 10 year official TB notification records, and a geographical infor mation system. Results-The case notification rate of TB in children 0-5 years old was 3588 cases/100 000 children aged 0-5 years, 3.5 times the case notification rat e in adults. Children (0-14 years) accounted for 39% of the total case load . Childhood TB case notification rate correlated with parental education (r =-0.64), annual household income (r =-0.6), and crowding (r =0.32). Conclusion-Children, especially those Living in poor socioeconomic conditio ns, form an important epidemiological group and account for a notable propo rtion of the morbidity caused by TB. Efforts to improve TB control must the refore not only target adults (case detection and cure of infectious cases) but also children (screening of child contacts of adult cases) and the soc ioeconomic living conditions.