Tuberculosis prevalence, risk factors, and psychiatric comorbidities in primary school Egyptian children

This study aimed to determine the prevalence of tuberculosis and to test for the risk factors and psychiatric disorders among children of primary school of different age groups whether vaccinated or not with BCG as well as designing a clinical survey setting elementary school in the scholar years 1989-91 in different areas of Cairo. The subjects of this study were 16109 pupils [9049 males [7985 vaccinated and 1064 non-vaccinated] and 7060 females [6021 vaccinated and 1039 non- vaccinated of whom 50 were non-tuberculous and served as controls. All children were subjected to the following investigations: Tuberculin testing, radiological investigations, complete medical examination, two questionnaires presented to parents and teachers, IQ assessment, structured psychiatric interviewing based on DSM III criteria and a modified junior EPQ for personality assessment. Results of this study showed that active TB was found in 0.31% of school children with age range 6-13.5 years [50%], symptoms and signs of TB positive family history of contact was found in 22% of total cases, the prevalence of extrapulmonary and pulmonary TB was 6% and 94%, respectively. When compared with a matched control group they showed higher neuroticism and less sociability, the difference was statistically highly significant and more behavioral as well as emotional disturbances in the form of food refusal, night terrors and mares, attention deficit disorders without hyperactivity, anxiety, depression and adjustment disorders. Moreover, impaired scholastic achievement was noted. The current work recommended early detection and prompt treatment of TB among adults and children and psychiatric skill training of school physicians for the best possible learning environment and health of children