Childhood tuberculosis in the State of Qatar: the effect of a limited expatriate screening programme on the incidence of tuberculosis.
OBJECTIVE
To determine incidence rates and the effectiveness of the expatriate screening programme on paediatric tuberculosis (TB) in the State of Qatar.


METHODS
A state-wide, population-based, retrospective analysis of all cases of tuberculosis among children 0-14 years of age reported to the TB Unit of the Division of Public Health during 1983-1996.


RESULTS
One hundred and forty-four children with tuberculous disease were identified, with a steadily declining incidence rate (rate of notification) from 11/100000 children (0-14 years) population in 1983 to 7/100000 in 1996. This decrease in the childhood TB case notification rate correlated with foreign-born children, older children and the implementation of expatriate screening in 1986. Diagnosis in 56% of children was made abroad or within 3 months of arrival from vacation and 30% within one year of arrival. Comparison of the three age groups (<5, 5-9 and 10-14 years) showed no significant difference with regard to nationality, sex, type of TB, radiological findings and screening. However older children were more likely to be symptomatic (P < 0.0001) and to have positive tuberculin skin test (TST) reactivity (P = 0.012), culture (P < 0.0001), and gastric aspirates (P = 0.018).


CONCLUSIONS
Although there was a 36% decrease in paediatric TB incidence after the implementation of expatriate screening in 1986, Qatar has a high rate of paediatric tuberculosis. The policy of BCG vaccination at birth should be continued, and screening children at school entry and on return from vacation would be useful for further case identification.
Al-Marri
M R
MR
Qatar Armed Forces Medical Unit, Pulmonary & Critical Care and Sleep Medicine, Hamad General Hospital, Doha. dhafi@qatar.net.qa
D000293:Adolescent; D017677:Age Distribution; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000706:statistics & numerical data*; D011780:Qatar / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D014374:Tuberculin Test / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents