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World Health Organization
96
April
TUBERCLE
divided betn~'een urban and rural areas. Luxemburg is the only town with a population over 50,000. The standard with regard to nutrition is high, resembling Belgium. The mortality per IOO,OOO from all forms of tuberculosis was 33"3 in I946 , 47.6 in 1947, 42"~ in I948 , and 45.1 in ~949. These mortality rates are based on 154, 96, i38 and I21 deaths. T h e disease is widespread and no one of the thirteen cantons was without at least two deaths. The control of tuberculosis is vested in the Central Office of Public Health, but no separate division for tuberculosis exists. BCG vaccination is coming into use with vaccine from Paris. There are ten dispensaries distributed over the Duchy; but many open cases are considered to be undetected in the country. Indeed, mass radiography surveys places the number as not fewer than 400. Some 360 beds are available and a sanatorium for children is projected. All the usual units in an anti-tuberculosis scheme exist; but enthusiasm on tile preventive side is not an outstanding feature. No information is available concerning the incidence of bovine tuberculosis. W O R L D H E A L T H O R G A N I Z A T I O N . Le Programme de Lutte Antituberculeuse en Tunisie. Doctor Masselot and Doctor Goujou. February 195o. In Tunis out of the population of 3,23I,OOO, Mussulmans claim -,9o3,949; the only large town is Tunis with some 6oo,ooo inhabitants; it has nearly doubled in the last fifteen years. The next largest town is Bizerta with 54,637 inhabitants. French and Italians form an inconsiderable proportion of the population. As the country passes from the Mediterranean seaboard on tile north ,and east, it fades away into tile waterless desert. Reliable vital statistics are only available for the city of Tunis. Half the population was under 2o years of age and only some 7 per cent over 60 years of age. The distribution by age and sex of deaths from all forms of tuberculosis for the three years x946-48 was as follows: Wumber of deaths Age-period Females 3Iales o-
4~ 36 39 58 267 95 ill122 157 '-'O-37 a 718 ,tO-I 13 459 6O-36 ~19 Note the excess of male deaths throughout life, particiflarly in adult life. When Mussulmans only are considered, there were 1,458 male deaths to 67o female deaths. The number of x-
1951
deaths has been steadily increasing year by year out of proportion to the increase in the population, but non-pulmonary deaths have not increased. The total death-rate ma t ' be roughly estimated as 4oo per Ioo,ooo. Positive skin reactions among school children were 44 per cent at age 6, rising to 7o per cent at age I5; the percentages were rather lower for European and Israelite children. The reproduced graph shows how the percentage of reactions increases with age, and are higher in tile populations with tile hlgher mortalities from the disease. Some x-ray surveys have also indicated the greater Percentage Of Positive Tuberculin Reactors by Race in Tunis Schoolchildren ;-
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prevalence of tubei'culosis among the mussulman population. Information becomes untrustworthy as urban districts give way to outlying areas, where life in tents is entirely primitive, inadequate to keep out rain or dust storms, lacking in an t ' sanitation, and hopelessly overcrowded. The country has not yet recovered fi'om the devastation of war and a large proportion of tile population is undernourished; tile carbohydrate element of tile food is especially low. As late as 1947 official recognition was given to a fight against tuberculosis and an effort is on foot to bring together previous efforts to tackle the problem. Much awaits the doing, especially with regard to keeping statistics. Dispensaries are being steadily established in all the townships throughout the country and are being regularly used. T r a v e l l i n g x-ray units are coming into use. BCG vaccination is planned.
April
TUBERCLE
divided betn~'een urban and rural areas. Luxemburg is the only town with a population over 50,000. The standard with regard to nutrition is high, resembling Belgium. The mortality per IOO,OOO from all forms of tuberculosis was 33"3 in I946 , 47.6 in 1947, 42"~ in I948 , and 45.1 in ~949. These mortality rates are based on 154, 96, i38 and I21 deaths. T h e disease is widespread and no one of the thirteen cantons was without at least two deaths. The control of tuberculosis is vested in the Central Office of Public Health, but no separate division for tuberculosis exists. BCG vaccination is coming into use with vaccine from Paris. There are ten dispensaries distributed over the Duchy; but many open cases are considered to be undetected in the country. Indeed, mass radiography surveys places the number as not fewer than 400. Some 360 beds are available and a sanatorium for children is projected. All the usual units in an anti-tuberculosis scheme exist; but enthusiasm on tile preventive side is not an outstanding feature. No information is available concerning the incidence of bovine tuberculosis. W O R L D H E A L T H O R G A N I Z A T I O N . Le Programme de Lutte Antituberculeuse en Tunisie. Doctor Masselot and Doctor Goujou. February 195o. In Tunis out of the population of 3,23I,OOO, Mussulmans claim -,9o3,949; the only large town is Tunis with some 6oo,ooo inhabitants; it has nearly doubled in the last fifteen years. The next largest town is Bizerta with 54,637 inhabitants. French and Italians form an inconsiderable proportion of the population. As the country passes from the Mediterranean seaboard on tile north ,and east, it fades away into tile waterless desert. Reliable vital statistics are only available for the city of Tunis. Half the population was under 2o years of age and only some 7 per cent over 60 years of age. The distribution by age and sex of deaths from all forms of tuberculosis for the three years x946-48 was as follows: Wumber of deaths Age-period Females 3Iales o-
4~ 36 39 58 267 95 ill122 157 '-'O-37 a 718 ,tO-I 13 459 6O-36 ~19 Note the excess of male deaths throughout life, particiflarly in adult life. When Mussulmans only are considered, there were 1,458 male deaths to 67o female deaths. The number of x-
1951
deaths has been steadily increasing year by year out of proportion to the increase in the population, but non-pulmonary deaths have not increased. The total death-rate ma t ' be roughly estimated as 4oo per Ioo,ooo. Positive skin reactions among school children were 44 per cent at age 6, rising to 7o per cent at age I5; the percentages were rather lower for European and Israelite children. The reproduced graph shows how the percentage of reactions increases with age, and are higher in tile populations with tile hlgher mortalities from the disease. Some x-ray surveys have also indicated the greater Percentage Of Positive Tuberculin Reactors by Race in Tunis Schoolchildren ;-
Y,
$
~
?
0
9
Do
i~
i~
~
i$
15
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prevalence of tubei'culosis among the mussulman population. Information becomes untrustworthy as urban districts give way to outlying areas, where life in tents is entirely primitive, inadequate to keep out rain or dust storms, lacking in an t ' sanitation, and hopelessly overcrowded. The country has not yet recovered fi'om the devastation of war and a large proportion of tile population is undernourished; tile carbohydrate element of tile food is especially low. As late as 1947 official recognition was given to a fight against tuberculosis and an effort is on foot to bring together previous efforts to tackle the problem. Much awaits the doing, especially with regard to keeping statistics. Dispensaries are being steadily established in all the townships throughout the country and are being regularly used. T r a v e l l i n g x-ray units are coming into use. BCG vaccination is planned.