The evolution of tuberculosis infection among schoolchildren in Barcelona and the HIV epidemic.

SETTING

First grade students in primary schools in the city of Barcelona, Spain.

OBJECTIVE

To estimate the prevalence of tuberculin reaction and sources of infection; to analyse trends in comparison with previous data.

DESIGN

Tuberculin screening of first grade schoolchildren (1985 birth cohort) was undertaken in 1991-92 using 2 TU of PPD RT23.

RESULTS

The prevalence of reactors among the 12,007 children tested from the 1985 cohort was 0.87%, varying among districts between 0.13% and 3.03%. Follow-up of positive tests was completed for 75 children, which led to the identification of 6 cases of previously unknown clinical tuberculosis among these children, while for 14 infected children index cases were found, one of whom was a confirmed HIV-infected IVDU.

CONCLUSION

The comparison of results with data from previous studies suggests that tuberculosis infection among schoolchildren in Barcelona may not be declining as in previous years, especially in areas such as the inner city, where poverty combines with HIV infection and with increasing migration from countries with a higher tuberculosis prevalence.