New Delhi, Mar 23: Despite nearly four decades of the national tuberculosis control programme, tuberculosis continues to be a major public health problem in the country with "very high" prevalence rate of infection in urban slums, a study has said. "Because of increased population mobility due to urbanisation, the socio-economic and environmental conditions become deplorable in slums," the study by a team of scientists at the department of preventive and social medicine, B J Medical College, Ahmedabad, published in 'Indian pediatrics' said.
The multiplicity of health care agencies and inappropriate diagnostic and treatment practices in the private sector in cities make the situation worse, the team said.
The scientists conducted a survey in urban slums of Ahmedabad city to estimate the prevalence of infection. A total of 210 children, who had not received immunisation for tuberculosis, were tested in 30 selected slum clusters with seven children in each cluster. The children were below the age of 15 and the median age was about six.
The prevalence of infection was found to be 30.4 per cent with 64 children showing positive results for the tuberculosis test. In a similar study, high annual rate of infection (ARI) of three per cent was observed among urban slum children in Chooli in Chennai.


Association between poverty and tuberculosis is well established. Even within the developed world the highest rates of disease are seen in the poorest sections of the community, the study said.
Warning that the TB epidemic was growing larger and more dangerous each year, the scientists said there had been no perceptible change in the epidemiology of TB since the national sample survey of 1956-57.
The national programme has not been able to make a dent on the epidemiology of TB due to several operational and managerial constraints although highly effective regimens of treatment are available.
Mere existence of control programme does not guarantee the involvement of workers in community, it said. Bureau Report