Prevalence of pulmonary tuberculosis on the roof of the world.
METHODS
The Shimshal Valley, a remote village in Northern Pakistan, is one of the seven Pamirs of Central Asia, widely known as the roof of the world.


OBJECTIVE
To investigate the prevalence of pulmonary tuberculosis (TB) in the Shimshal Valley.


METHODS
The Rapid Village Survey Method (RVS) was used to investigate the prevalence of pulmonary tuberculosis. The selection criteria were chronic cough, hemoptysis, past history of TB and close contact with a tuberculous patient. After clinical examination, a chest radiograph was done and a single spot sputum sample was obtained for smear examination.


RESULTS
The total population of the village was 1077, of whom 231 cases were studied. Overcrowding affected 75% of the study population. The prevalence of smear positive pulmonary TB in the village studied was 554 per 100000 population, and the prevalence of active smear-negative TB was estimated at 1949/100 000. The prevalence of active pulmonary TB increased with age and the only risk factor for active TB was age over 45 years. Of the 21 cases with a past history of pulmonary TB, only 38% had completed a full course of chemotherapy.


CONCLUSIONS
Pulmonary TB is a very serious health issue in the rural community (Shimshal Valley) of Pakistan. This study highlights the lack of efficacy of national tuberculosis control programs in the country.
Alvi
A R
AR
Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
Hussain
S F
SF
Shah
M A
MA
Khalida
M
M
Shamsudin
M
M
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*