Salmonella carriage rate amongst school children--a three year study.

As a part of three-years epidemiological survey of salmonellosis in South Kanara District, a southwest coastal region of India, an attempt was made to determine the human Salmonella carriage rate during the period between 1981 to 1983. One thousand and two asymptomatic school children 5 to 15 years of age, 42 restaurant employees and 17 dairy workers formed the subjects of this bacteriological study. The Salmonella carriage rate among healthy school children from a single fecal sampling was 1% and no Salmonellae were recovered from the feces of restaurant and dairy workers. Ten school children excreted Salmonellae which belonged to 6 different serotypes-Salmonella oslo, S. ohio, S. typhimurium, S. urbana, S. cerro and S. derby; S. oslo and S. ohio were the most frequent serotypes. No-S. typhi, S. paratyphi A or S. paratyphi B were recovered. All Salmonella strains recovered during this study were dual or multiple drug resistant, sulfadiazine and tetracycline resistance being commonly observed. The significance of excretion of potentially pathogenic, drug resistant Salmonellae by symptomless school children is discussed from public health point of view.

Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries

The value of programmes to control pulmonary tuberculosis in developing countries remains the subject of debate. We have examined the cost-effectiveness of chemotherapy programmes for the control of pulmonary sputum-smear-positive tuberculosis in Malawi; Mozambique; and Tanzania. Effective cure rates of 86-90 percent were achieved with short-course chemotherapy and of 60-66 percent with standard chemotherapy. The average incremental costs per year of life saved were US $1.7-2.1 for short-course chemotherapy with hospital admission; $2.4-3.4 for standard chemotherapy with hospital admission; $0.9-1.1 for ambulatory short-course chemotherapy; and $0.9-1.3 for ambulatory standard chemotherapy. Chemotherapy for smear-positive tuberculosis is thus cheaper than other cost-effective health interventions such as immunisation against measles and oral rehydration therapy. Because the greatest benefit of chemotherapy is reduced transmission of the bacillus; treating HIV-seropositive; tuberculosis smear-positive patients would be only slightly less cost-effective than treating HIV-seronegative; tuberculosis-smear-positive patients