Tuberculosis in a common lodging-house.

In most European countries tuberculosis mortality has been decreasing during the last few decades, but this decrease has not been uniformly experienced by all age and sex groups (Clarke, 1952; Cheeseman, 1952). Generally, old men as a group have benefited least and this contention is supported in some countries by the trends of notification rates (Cheeseman, 1956; Lowe, 1954; Stocks, 1950; Ministry of Health, 1958). Residents of common lodging-houses in Northern Ireland are mostly old men and their experience of tuberculosis has not been studied with the detail which the apparent vulnerability of this age and sex group would appear to demand. This paper describes a study of the disease in one particular common lodging-house in Belfast and assesses its importance as a focus of infection in the Belfast community. Laidlaw (1956) reviewed 125 persons in Glasgow suffering from tuberculosis who gave as their place of residence a common lodging-house or a working men's hostel. Of these 34 (27 per cent.) refused to co-operate in any way after diagnosis, and a further 27 (22 per cent.) did not co-operate fully in hospital or out-patient treatment. Tuberculosis was the fourth commonest cause of death amongst lodgers in Glasgow common lodging-houses, accounting for one tenth of all deaths during 1950-53, the average length of survival after diagnosis being 3 years. In a recent survey of tuberculosis in Glasgow, 860 residents of common lodging-houses were visited and offered examination by mass miniature radiography. Only 193 (22 per cent.) accepted and of these 67 were referred to a chest clinic. Only 56 attended, among whom 22 were found to have significant pulmonary tuberculosis (i.e. 26 per 1,000 residents originally visited). Of those admitted to hospital the majority were either prematurely discharged because of ill-behaviour or left against advice (Geddes, 1959).