| Yes, it is a hidden disease. The patient remains | | | | diagnosis/activity of tuberculosis, either in a mass |
| asymptomatic for long periods, and the disease is | | | | surveyor in an individual. Hence, when the disease is |
| often diagnosed during routine tests, when a chest | | | | suspected, other tests, must be carried out, including |
| X-ray reveals the 'hidden' disease, i.e. tuberculosis. It | | | | a detailed clinical examination,'keeping the |
| has thus an occult/hidden character. | | | | symptomatology of the patient in view. |
| In places where the incidence of tuberculosis is not | | | | Also, in the MMR study, small X-ray films taken may |
| marked, 'tuberculin test surveys' be carried out | | | | not give the true picture of the disease. And, there |
| among the general population, which gives an idea of | | | | even may be variations in reading these X-ray films. |
| the number of cases who are tuberculin positive, i.e. | | | | Even if a tubercular lesion appears to be positive, it |
| infected with tubercle bacilli (although the disease | | | | must be confirmed by a large chest X-ray, as well as |
| may be inactive in the majority of them). Those who | | | | by other tests. It is never wise to administer |
| have shown positive in the tuberculin test should be | | | | treatment of tuberculosis to a patient only on the |
| subjected to an X-ray examination of the chest, so | | | | basis of miniature radiographs. |
| as to find out hidden/ symptomless, especially active | | | | The MMR study is now no longer widely carried out |
| cases of the disease - in other words those who are | | | | in places/ countries where the incidence of |
| suffering from active tuberculosis, but still showing no | | | | tuberculosis is low, because too few cases may be |
| symptoms of the disease, can be detected. | | | | found positive, involving the expense of a lot of time, |
| For an epidemiological survey, small X-rays may be | | | | money, and above all, at the risk of exposure to |
| taken through a special X-;ray plant fitted in a van, | | | | X-ray radiation for a large population. |
| which moves from place to place or village to village, | | | | Also, in all those groups of persons who daily come in |
| or visits poor communities/slums. X-rays are taken in | | | | contact with a large number of people, such as the |
| quick succession, one by one, of the various persons, | | | | bus-drivers, conductors, teachers, and the entire |
| who 'are made to stand in a queue before entering | | | | medical staff, like doctors, nurses, attendants, |
| the van. They come out of the van after the | | | | technicians, radiographers etc., chest X-rays should be |
| exposure for the chest X-ray. This is called miniature | | | | carried out because they comprise the high-risk |
| mass radiography (MMR). These surveys were most | | | | groups. Spread of the disease has also been noticed |
| common in the past when the disease was at its | | | | in creches, schools, school-buses, hostels, and even in |
| peak. | | | | nursing homes, etc. |
| However, in places where the incidence of | | | | Similarly, the disease must be detected in servants, |
| tuberculosis is high, all persons in such areas are | | | | waiters in restaurants, salesmen, postmen, |
| expected to be infected with tubercle bacilli, i.e. they | | | | washermen, sweepers, barbers, cobblers, etc. People |
| will be found as tuberculin positive. Hence the | | | | living in slums and shanty towns, chawls, etc. should |
| tuberculin test is of little value at such places, for | | | | also be checked for the detection of tuberculosis. |
| epidemiological survey, and therefore, one can | | | | All efforts must be made to unearth 'hidden' cases of |
| directly switch on to MMR study, for the detection | | | | tuberculosis, as they are most dangerous to society. |
| of both hidden and active cases of tuberculosis. | | | | They go on spreading the disease for a pretty long |
| It may, however, be noted that X-ray of the chest | | | | time, till it is diagnosed and treated. |
| alone may not be always confirmatory of the | | | | |