Since July 1958, tuberculiu tests and x-ray examinations have been carried out perio
dically or 2341 children from 3 primary schools, which from 3 primary schools, which
are located near the Inchon Red Cross T.B. Sanatorium. The purpose of this was to get
some data on the course of tuberculosis in primary school children.
All the 3 schools are located in smalvillages, lying some 4 to 10 Kms away from he
center of Inchon city, The parents were mostly farmers.
In July 1956, tuberculin tests were made. and the children were classified in the two
groups (1) tuberculin positive and (3) tuberculin negative. Then microfilms we taken of
all the che children, including the tuberculin negative group.
Periodic tuberculin tests were given to the tuberculin group at an interval of 4 to 5
months to find the convertors. These positive cases who were hem x-rayed with
regulasize film, blood sedimentation tests made and complete physic examine ations
carried out.
In all 1957, for the second time, Apriofilms we re taken of the tuberculin positive
group in order to carried out how many new cases o fineveloped from this group.
(For those cases which were found to need treatment or supervision at the first mass
x-ray, follow-up x-ray examinations were given in April and Sept. 1957 respectively, to
determine the course of the disease curing that period).
(Treatment had been discontinued for the most part due to leck of understanding of
their parents).
The following results were obtained from this study:
1)The percentage of tuberculin positive reactors was 37%, 42% in the three school
respectively The percentage of the positive reactors varied between 20% & 32% in the
first grades; 45% & 56% in the 6th grades.
2) Nearly 8% of negative reactors were converted to positive during the period of the
14 months.
The conversion rate seems to vary with the season.
3) As a result of this survey, 103 cases(4.4% of all children) were found to need
treatment or supervision, among them were 35 cases out of 65 new convertors discover
during this study.
4) of the 103 cases above mentioned, more than 70% were simple primary t.b., ab out
20% were chronic pulmonary t.b. (reinfection type) or suspected cases, and the re
maining 10% consisted of 3cases of pleurisy, 4 cases of segmental lesion, 1cases of
hematogenous disseimnated type.
5) Of the 1027 negative reactors in the mass x-rays of July 1956, 18 cases had
thrown abnormal x-ray shadows. Of these 8cases, include 5 cases whose tuberculin
react on became positive afters, and 3cases needing treatment and for supervision. This
would indicate that the tuberculin reaction is one of the most useful methods for
scaeenining out F.B., even though it is not absolutely dependable.
6) Of those cases needing treatment or supervision, only 10% becomes worse after
1years, the rest of them improved or remained unchanged.
7) Compared with the 3.5% at which rate new cases are supposed to develope from
positive reactors group, 54% of the new convertors showed roentgenological changes and
38% required tueatment.
8) Of the roentgenological changes discovered early following conversion, 68% the
majority) was hilar node t.d., 23%(was primary complex, and the remaining 9% was
pleurisy or segmental lesion. Most of these change appeared at the same time when
conversion was found, though we realize that segmental lesion may appear early or later
following Development to chronic type from primary T.B. began to appear 5 to 10
months following conversion.
9) Blood sedimentaion rate and degree of reactivity to tuberculin of new convertor s
seem to have some relationship to the development of tuberculosis.
10) Of the new convertors, about 40% had subjective complaints ranging from several
months.
11) Chronic type (reiufection type) seems to occur somewhat more frequently in the
children, but may be found even in the lst grade.
The extent of the lesions was minimal for most cases.
12) In view of the fact the calcified lesions coexisted with the chronic type lesions in
about 30% of the whole chronic type cases, the time relationship of development of
chronic type to primary t.b. seems to be inconstant.
In summery, the general tendency of t.b. in primary school children seems to be as
follows: About a half of the new convertors show roentgenological changes, and the
simple primary pulmonary t.b. constitutes the main problem in primary school children.
The Chronictype begins to appear on he on hand, but hematogenous spreadlso may
occurrarely, and occasionally pleurisy or segmental lesion may develop.
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