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April 1960 - July 1961 WHO EMRO EM/TB/84 EM/ST/26 Page I

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April 1960 - July 1961 WHO EMRO EM/TB/84 EM/ST/26 Page I IDRlD HEALTH ORGANIZATION EN/TB/84 Reg~onal Off~ce for the EH/sT/26 Eastern Me~terranean September 1962 TUBERCULOSIS PREVALENCE SURVEY IN THE HASHEMITE KINGOOM OF JORDAN April 1960 - July 1961 WHO EMRO EM/TB/84 EM/ST/26 page i TABLE OF COFTENT& I INTroDUCTION 4/1 ................................... ~ • ••••• •• •••• 1. II BDPULATION ••••••••••••.••••.••..•••••.•. , ••••••••••••• ~..... 1 III SAMPLING METHODS ••••••••••••••••••••.••.•••••••••••••••••••• 2 IV METHODS OF EXAMINATION 1, Tubercul1n Test1ng •••.•••••••••••••.•••.•.•••••••••••• ~ J 2, X-ray Exam~nat~on ••.••••••••••••••••••••••• ~ ••••••••••• 3 3. Bacter~olog~cal Exam~at~on of Sputum •••••••••••••••••• 4 v SAMPLE POPULATION •.............•...........•..••.•.......•• 4 VI RESULTS 1. Tubercul1TI Teat1ng •••••.• , •••••••••••••••••••••••••••• 4 X-ray Exam1nat1on •••••.•••••••.•••••••••••.••••••••••• 6 Bacter101og~cal Exam~nat1on •••••••....•••..•.•.•••••.• 7 VII CONCLUSIVE RESULTS OF THE TI-Kl SURVEYS ...................... 7 VIII S~ ........................................................ 8 ANNEX I Table 1 Sample Populatlon, Exa~natlons done and Extent of Part~clpations Table 2 The Sample Populatlon by Age and Sex Table 3 Tempo~ry Abs~ntees DlStrlbutl0n by 11.ge and Sex Table 4 Reason for Absenteelsm by Age and Sex Table 5 D~strlbut~on by S~ze of Reactlon to Mx 1 TU In specrl~ed age-group Table 6 D~str~butl0n by Slze of Reactlon to ~~ 1 TU In spec~fled Age-group EM/TB/54 WHO EMRO EM/ST/26 page J.i TABLE OF CONTENTS (cont'd) Table 7 - DJ.strJ.butJ.on by ~ze of ReactJ.on to r-Ix 1 TU J.n specJ.fJ.ed Age-group Table 8 - Percentage DistrJ.butJ.on by SJ.ze of ReactJ.or t-Q Mx 1 TU by Age-gro\lp Table 9 - Percenta~~ ~+$tr+bvt+oo by SJ.ze of ReactJ.on to Mx 1 TU by Age-group Table 10 - Percentage DJ.2trJ.butJ.on by SJ.ze of ReactJ.OI) to }r~ 1. '.[U by Age-group iable 11 - Estimated Preval~nce of Tuberculous InfectJ.~n by Age and Sex Total PopulatJ.on Table 12 - EstJ.mated Prev2lenc6 of Tuberculous Infectl0n by ~ge, Sex and Place of ResJ.dence Table 13 Scars from preVJ.ous EGG Vacclnatl0n Table 14 - SJ.ze of Tuberculln Reactlon among Persons WJ.th defJ.nJ.te or doubful Scars, J.DdJ.catJ.pg preVJ.ous BCG VaccJ.natJ.on Table 15 - Type of Tubercul~n ~eact~on and 1t.s. Relatlon to Re~ctlon Slze - Total S~mple Populatl0n Table 16 - Results of X-Ray ExaID1natJ.on by S~3mple Group Table 17 - Results of X-Ray Ex~mJ.natlon by Age ond Sex Table. 18 - X-Ray Flnd1ngs by Slze of Tuberoulin ReactJ.on Table 19 - X-Ray Flnd1ngs by Slze of ReactJ.on to the Mx 1 TU Teat - Urban and Rural Areas Table 20 - Estlmated Prevalence of Tuberculous Infectl0n by Sex and Age - Jllml~n Survey and NatJ.onal Survey Table 21 - X-Ray Flndlngs by Slze of Tuberculln Reoctlon - Beth Surveys WHO EMRO EH/TB/84 EM/ST/26 page l.ll TABLE OF 'XlNTENTS (cont'd) ANNEX II Fl.gure 1 - Frequency Dl.strl.butl.on of Sl.ze of Tubercull.n Reaction by Sex - All Groups Fl.gure 2 - Frequency Distrl.butl.on of Sl.ze of Tubercull.D Reaction by Aee - Total Population Flgure J - Age Infectl.on Curve for the Total Sample Populatlon, by Sex (Infected Persons - Tubercull.D Reactl.on of 10 mm or more) Fl.gure 4 - Age Infection Curve by Sex and Place of Resldence Fl.gure 5 - Type of X-Ray Flndl.ng b,y Sl.ze of Tubercull.n Reactl.on WHO EMRO EM/TB/84 FJ!!./ST/26 page 1 I INTRODUCTICN A country-~~de tuberculos~s prevalence survey has been conducted ~ the Hashe~te K1ngdom of Jordan from April 1960 to July 1961. The survey was carrled out under the directlon of the Mlnlstry of Health and ~th technlcal ass~stance from WHO. Ass1stance was glven by UNICEF ~ the form of eqUlpment and supplles. The a1m of the survey was to collect lnformat10n on the prevalence of pulmonary tuberculos1S and of tuberculous 1nfect10n in the Country. The survey conslsted of the exammation by three standarcb.zed cl:Lagnost~c tests of a sample of the Jord2nlan populatlcm. The samp11ng Tias done accord1ng to a ran~om procedure wh~ch 1n pr1nclple gave all the mhab~tants the same chance of bemg lnc1ude~ thus ensuring that the sample would be representat1ve of the populatlon from ..Inch it was drawn. The survey was carr~ed out m two phases. The f~rst phase cons~sted of the overall plannlng and the examlnat~on of e~ght groups selected ~n Amman d1str~ct (mclud~g Amman town) and was Conducted by the Reg~onal Tuberculos~s Survey Team of the 1'IHO Reg~onal Off~ce for the Eastern MedJ.terranean. The second phase cons1sted of the examlnat10n of t huty-three selected groups an d was carr1ed out by the Rat~onal Tuber~ulos1s Prevalence Survey Team who had been tra1ned in all aspects of survey work by the Reg~onal Tuberculos1S Survey Team durmg the first phase of the survey. The procedures followed are the same for both phases of the survey whlch makes the obtained results directly ccml3Brable. For conven~ence the fp'st phase of the survey Tn:!.l be referred to In thlS report as the Amman Survey, and the second phase u1ll be referred to as the Nat10nal Survey. The results obta1ned In the Amman Survey have been presented m the report "TuberculoslS Survey m Amman, The Hashem~te Klngdom of the Jordan", Alexan dna, Un1ted Arab Repubhc (June 1961), and 1-I'ill be dealt inth only bneily here. Th1S report Wlll present the results obta1'ned m the Nat10nal Survey and also glve some overall estlmates. II FOPULATION Jordan bas a populatlon of approXlmately 1,400,000 of unlcb about 600,000 are 11Vlng m urban areas. These f1eures lnclude some 500,000 Palest~ne refugees of whom 38% 11ve In camps. The moving bedoUln populatlon 1S about 30 - ~,OOO. The pr~nc~pal towns are Amman and Arab Jerusalem. A'T\ITlan lS the capl tal and has about 170,000 mhabitants. Arab Jerusa'lem, for the llost part tbe old C1ty, has a populatlon of about 100,000. ENjTB/84 WHO Et·rRD Fl'J./ST/26 page 2 III S.JIlvIPLING l"lETHODS The P~lest~ne refugees l~~ng ~n camps are under separ~te adm~n~str~t~on and have been excluded from the survey. Excluded were also people l~~g ~ m~l~tary establ~shments. Jordan ~s adm~n~str~t~vely ~~ded ~to e~ght d~str~cts. Groups were allocated to the d~ferent ~str~cts accord~ng to population. No ~str~ct was allocated less than two groups. W~th~n each d~striot groups were ~str~buted between urban and rural ~reas accord~g to populat~on. A total of forty-one groups were selecte~ twenty-one ~n urban ~nd twenty ~ rural areas .. The procedure for select~g groups ~ rural ~reas ~ns~de a d~str~ct was as follows: The l~st of ~llages from the last census (1952) was obt~~n6d and ~th the ~elp of local author~t~es checked and adJusted ~n order to make ~t as up-to-date ::s pos~ble. Sm311 Vl.llages were comb~ed ~th ne~ghbour~g ~llages so that no ~llage or group of Vl.llages had less than 500 ~nhab~tants. As a f~rst-stage sampl~n~ the requ~red number of ~113ges were randomly selected from the Vl.llage l~st us~g the populat~cn f~gures as we~ghts. F~nally, as a second-stage sampll.ng, one household was randomly selected from the l~st of households to ~n~cate the f~rst household to be exa~ned. The survey team's census takers started reg~strat~on ~n the selected household and e6ntLnued ~ the houses w~th consecut~vely h~gher numbers ~ the l~st of households unt~l approx~atcly 300 persons had been reached. All persons l~~g ~ the last household were reg~stered ~rrespect~ve of number. The select~on of groups ~n urben areas w~th~n a d~str1ct was performed in the follo~ng way: In ~str~cts ~th more than one tOlm, the groups were d~stnbuted between the towns accord~ng to the number of ~nhab~tants. For each town where one or more groups were to be selecte~ a llst of houses was obta~ned from the tax collector together ·nth a map on wh~ch quarters or blocks were marked. As a f~rst-stage sampl~g, the reCluued number of quarters or blocks were randomly selected us~ng the number of hcuses ~n e~ch quarter or block as we~ght. F~nally as [),' IiIBoond-stClge sampl~ng, one house was randomly selected ~ each selected quo.rter or block from the l~st of houses. The survey team's census takers started reg~strat~on ~n the selected house 3nd cont~nued in the houses W1th consecuuvely h~ghcr numbers ~ the l~st of houses, unt~l appro~ately 300 persons had been reached. All persons ~n the last house were reg~stered ~rrespect~ve of number. w.:-ro EHRD EM/TB/84 BlI/ST/26 page 3 All persons belong~ng to the selected households were reg~stered. Temporar~ly present persons, ~.e. ~s~tors who expected to sleep actually dur~ng the night prior to the f~rst exam~nation day slept ~n the househol~ 1..rere also regl.stered and ~ncluded 1n the sample. Persons reported tempo­ rar~ly absent, 1.e.
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