RESUMO
OBJECTIVE: To understand better the characteristics of tuberculosis (TBC) in children and to identify sources of infection. DESIGN: Crossover study. SITE. At the community level in the city of Barcelona. PATIENTS: Children under 15 with tuberculosis, who were diagnosed between Oct 1, 1989 and Sept 30, 1990 and were resident in Barcelona. MAIN MEASUREMENTS AND RESULTS: Among the 78 cases found, we identified the source of infection for 26 children (33.3%). 6 of these (23.1%) had been infected by three cases of HIV+. A relationship was posited between the economic level of the population and the incidence of TBC. This was confirmed by the economic level of the families (80% of the sources of infection identified belonged to professions requiring few or no qualifications) and where they lived, given that the specific rate for children under 15 in the most depressed social-economic area (Ciutat Vella) was 206 per 100,000, whereas in the wealthiest area (Sarrià-Sant Gervasi) the rate was 4.3 per 100,000. CONCLUSIONS: This study makes clear the importance of investigating the contacts of children with tuberculosis. It should be fundamental for the TBC control programmes to focus closely on those with HIV. They are much more likely to contract and spread TBC to the least protected groups of the population, especially to the children of poor families.
