(ARTI)(1). Tuberculosis control is defined as
cumulative prevalence of <1% infection by age 14
years (2-7). This translates to an average ARTI of
about 0.07% below 14 years of age(2-7). Currently
ARTI is about 1% per year in many regions of India
(5-9). In the absence of any baseline data from
western Uttar Pradesh, we conducted this tuberculin
uberculin surveys help us to estimate the
prevalence of tuberculosis
infection and to compute the annual
incidence (annual risk) of MTb infection
This study was conducted at a secondary-care
pediatric hospital in Bijnor, western Uttar Pradesh.
Ethical clearance was obtained from the ethics
committee of the hospital. The study population
consisted of children below 18 years, attending the
out-patient department (OPD) during October 2007
through September 2008. Every 4th child attending
the OPD was included, irrespective of the presenting
complaints, avoiding bias or possible non-random
clustering effect that might have occurred if all
children had been tested at one point of time.
Exclusion criterion was any illness that included TB
in the differential diagnosis.
The tuberculin skin test (TST) was performed
using the standard PPD RT23 with tween 80 (Span
Diagnostics, Sachin, Gujarat; dose equivalent to 5
TU old tuberculin). However, it is to be understood
that the 5 TU is equivalence value for
standardization - 2 TU PPD with Tween 80 has
potency equal to 5TU old tuberculin. Test result was
read after 48 to 72 hours by one of the authors and
recorded as the transverse diameter (in millimeters)
of palpable induration(1).
97VOLUME 47__JANUARY 17, 2010
S H O R T C O M M U N I C A T I O N
Prevalence of Mycobacterium tuberculosis Infection in
Children in Western Uttar Pradesh
VIPIN M VASHISHTHA AND T JACOB JOHN
From Mangla Hospital, Shakti Chowk, Bijnor, Uttar Pradesh, India.
This study was conducted to estimate the prevalence of tubercular infection and
compute the Annual risk of tuberculosis infection (ARTI) in Bijnor district of western
Uttar Pradesh through a hospital-based tuberculin survey conducted at a pediatric
hospital. A total of 1085 children below 18 years (0-4 years 866, 5-17 years 219),
attending the out-patient department during October 2007 through September
2008 were included. Tuberculin skin test using standard PPD RT23 with Tween 80
was performed on every 4th child attending the out-patient department and
induration was measured after 48 to 72 hours. Using a cut-off of 15 mm among 0-4
y aged children, the average prevalence rate was 7.4%, and using cut-off of 10 mm
in 5-17 y age group the average prevalence rate was 26.9%. ARTI was 4.11% (95%
CI 3.09-5.14) and 3.50 % (2.46-4.48), respectively in the two age groups.
Key words: Annual rate of tuberculosis infection, Child, India, Prevalence,
Tuberculin skin test, Tuberculosis.
Vipin M Vashishtha,
Director and Consultant pediatri-
cian, Mangla Hospital, Shakti
Chowk, Bijnor, Uttar Pradesh,
246 701, India.
Received: February 18, 2009;
Initial review: March 12, 2009;
Accepted: September 21, 2009.