Biomedical subjects
Publications and source records attributed to V H Springett.
The highest rate of tuberculosis notification in England and Wales during the 1980s occurred in males aged 65 years and over. This is explained on the basis of reactivation rather than recent infection: a trend which is likely to continue until the end of the century.
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The aims of this paper were to estimate the numbers of tuberculosis notifications in young white adults which will be prevented in the next 25 years by the schools BCG vaccination scheme, and to assess the numbers of additional notifications if the scheme were to be discontinued. Assuming that in the white ethnic group in England and Wales the decline in tuberculosis notification rates (8-10% per year for ages less than 45 years) and efficacy of BCG vaccination (75-80%) are maintained, it is estimated that the scheme for BCG vaccination of schoolchildren with its present coverage will prevent 217 notifications in those aged 15-29 years in 1993, 119 in 1998, and 69 in 2003. The epidemiological consequences of stopping the BCG in schools scheme, whenever this occurs, would be a substantial slowing of the rate of decline of tuberculosis notifications, confined almost entirely to the 15-29 years age group, for a period of about 15 years, after which the steeper decline would resume. If the scheme stopped at the end of 1991 the annual number of additional notifications would slowly increase to a maximum of just over 80 about 15 years later, and then decrease. For stopping at the end of 1996 the maximum annual number of additional notifications would be about 50.
Since the early 1960s notification rates for tuberculosis in England and Wales for the whole population have been influenced by high rates in certain ethnic groups. Using data based on country of birth from the British (Thoracic and) Tuberculosis Association surveys of 1965 and 1971, and based on ethnic origin from the Medical Research Council surveys in 1978/79 and 1983, rates for the white ethnic group have been estimated at those four times, and compared with the published rates for the whole population in 1953, when only a very small proportion was of non-white ethnic origin. Between 1953 and 1983 the notification rate for the white ethnic group fell from 122.2 to 11.3 per 100,000 for males, an annual decline of 7.7%, the corresponding rates for females being 90.1 and 5.8, an annual decline of 8.8%. The greatest annual declines occurred between 1953 and 1965, 9.4% for males and 11.2% for females. The annual declines in the most recent period, 1978/79 to 1983, were 6.9% for males and 7.3% for females. In both sexes the decline was greatest in the 15-24 year age group and least in the oldest age group, and this has led to a change in the age pattern of annual notification rates. The highest rates in both sexes occurred in young adults in 1953 but in the oldest age groups in 1983. There is however no evidence of any cohort experiencing an increase in notification rate with increasing age.
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Analysis of the month of birth of 1715 children with asthma shows clear evidence of a higher proportion of the group having been born between May and October (54.8%) than would be expected by comparison with the population of England and Wales (50.2%). Inspection of the distribution of month of patients with hay fever and for patients with positive skin reactions to mixed grass pollen does not account for this seasonal variation but children with positive skin reactions to Dermatophagoides pteronyssinus show a high proportion (56.2%) born in the period May to October. Although the reasons for the variation of pattern of month of birth in asthmatic children are uncertain, further study of sensitization in early life might clarify them.
I n 1971--4 forty-four patients were found to have drug-susceptible tubercle bacilli in their sputum more than one year after a previous positive result. Comparison of their case records with those of 45 controls showed that inadequate chemotherapy was by far the most important cause of relapse. Most patients who have had adequate chemotherapy for pulmonary tuberculosis should be discharged. Patients who have certain risk factors or who have had inadequate or irregular chemotherapy should be followed up indefinitely.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.