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a Department of
Paediatrics and Child Health, University of Stellenbosch, PO Box 19063, Tygerberg 7505, South Africa, b Institute for
Geographical Analysis, Department of Geography, University of
Stellenbosch, South Africa
Correspondence to: Dr van Rie
Accepted 5
December 1998
AIM
To study the
epidemiology of childhood tuberculosis (TB) in a developing country.
SETTINGTwo urban
communities of Cape Town, South Africa with a TB case notification rate
of 1149/100 000.
DESIGNRetrospective
descriptive study using the national population census (1991), 10 year
official TB notification records, and a geographical information system.
RESULTSThe case
notification rate of TB in children 0-5 years old was 3588 cases/100 000 children aged 0-5 years, 3.5 times the case notification rate in adults. Children (0-14 years) accounted for 39%
of the total case load. Childhood TB case notification rate correlated
with parental education (r = 
0.64),
annual household income (r = 0.6), and
crowding (r = 0.32).
CONCLUSIONChildren,
especially those living in poor socioeconomic conditions, form an
important epidemiological group and account for a notable proportion of
the morbidity caused by TB. Efforts to improve TB control must
therefore not only target adults (case detection and cure of infectious
cases) but also children (screening of child contacts of adult cases)
and the socioeconomic living conditions.
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