[Evaluation of the policies for detection of pulmonary tuberculosis in France].
A survey of 984 cases of pulmonary tuberculosis was carried out to assist French public health authorities in determining policies for pulmonary tuberculosis detection. The adjusted sample was representative of the totality of pulmonary tuberculosis cases reported. The survey made it possible to define the economic and socio-demographic characteristics (age, nationality, lack of social security coverage, living conditions) which, when combined, represent high-risk attributes with regard to pulmonary tuberculosis. Nonetheless, over half the subjects studied presented no risk factors. Systematic X-ray screening of an undifferentiated population permits detection of about 23% of reported cases; among them, 26 or 50% (depending on the definition of contagiousness chosen) were contagious. In 1982, 9 million systematic X-ray screenings were performed and about 13,100 cases of pulmonary tuberculosis reported. When extrapolated to these 1982 figures, our survey conclusions point to an effectiveness rate for systematic X-ray screening of 33.7 per 100,000 for the overall tuberculosis population, and between 8.9 and 17.4 per 100,000 for contagious cases. On the other hand, high-risk groups (female immigrants, the aged, etc.) do not seem to be particularly well covered by systematic X-ray screening. Thus, maintaining such a program no longer appears justified either in terms of the overall tuberculosis population or that of high-risk subgroups.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D005602:France; D006291:Health Policy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009790:Occupations; D011859:Radiography; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000208:ethnology
Contribution à l'évaluation de la politique de dépistage de la tuberculose pulmonaire en France.