Childhood tuberculosis in an urban population in South Africa: burden and risk factor.

AIM To study the epidemiology of childhood tuberculosis (TB) in a developing country. SETTING Two urban communities of Cape Town, South Africa with a TB case notification rate of 1149/100 000. DESIGN Retrospective descriptive study using the national population census (1991), 10 year official TB notification records, and a geographical information system. RESULTS The 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). CONCLUSION Children, 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.