High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study

Background Childhood tuberculosis (TB) has been neglected in the fight against TB. Despite implementation of Directly Observed Treatment Shortcourse (DOTS) program in public and private hospitals in Indonesia since 2000, the burden of childhood TB in hospitals was largely unknown. The goals of this study were to document the caseload and types of childhood TB in the 0-4 and 5-14 year age groups diagnosed in DOTS hospitals on Java Island, Indonesia. Methods Cross-sectional study of TB cases recorded in inpatient and outpatient registers of 32 hospitals. Cases were analyzed by hospital characteristics, age groups, and types of TB. The number of cases reported in the outpatient unit was compared with that recorded in the TB register. Results Of 5,877 TB cases in the inpatient unit and 15,694 in the outpatient unit, 11% (648) and 27% (4,173) respectively were children. Most of the childhood TB cases were under five years old (56% and 53% in the inpatient and outpatient clinics respectively). The proportion of smear positive TB was twice as high in the inpatient compared to the outpatient units (15.6% vs 8.1%). Extra-pulmonary TB accounted for 15% and 6% of TB cases in inpatient and outpatient clinics respectively. Among children recorded in hospitals only 1.6% were reported to the National TB Program. Conclusion In response to the high caseload and gross under-reporting of childhood TB cases, the National TB Program should give higher priority for childhood TB case management in designated DOTS hospitals. In addition, an international guidance on childhood TB recording and reporting and improved diagnostics and standardized classification is require

The pattern of notification and testing for genital Chlamydia trachomatis infection in Victoria, 1998–2000: an ecological analysis

Abstract Objective:This ecological study analyses routinely collected chlamydia notification and testing data to investigate any patterns. Methods:Age and sex‐specific chlamydia notification and testing rates for Victoria were calculated for the period 1998 to 2000. Results:Chlamydia notification and testing rates rose between 1998 and 2000. Notification rates were higher among women aged 15 to 24 years than men of the same age (p<0.01) and higher among 25 to 44‐year‐olds living in metropolitan rather than rural/regional Victoria (p<0.01). Testing rates were higher for women than men (p<0.01) and higher in metropolitan rather than rural/regional areas (p<0.01) in all groups except women aged 15–24 years. Conclusions:These increasing rates highlight that chlamydia infection represents a substantial public health problem. Implications:Although these data provide useful information showing these rates vary with age and sex, formal epidemiological prevalence and risk factor studies are required