The causes of a sharp rise in the proportion of Derby secondary schoolchildren found to be Heaf positive in 1974-1976 were investigated. The high prevalence of tuberculin sensitivity was confined to pupils attending schools with a high proportion of Asian children on their registers. Conversion rates were higher among Asian than indigenous children. The children had not been vaccinated with BCG. Environmental monitoring in one school failed to disclose any source of non-tubercular mycobacteria and examination of the staff and children failed to detect any evidence of tubercular disease. Differential tests showed a higher degree of sensitivity to Avian than to Mammalian (Human) PPD in children in one of the schools. A marked increase in the notification rate for tuberculosis in children of school-age occurred in 1976 and has since been maintained. Thirty-seven (73%) of 51 cases notified among secondary schoolchildren in the period 1975-1985 had Asian names and 42 (82%) were children who attended schools with more than 20% of Asians on the register. © 1988 The Society of Community Medicine.

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Short Survey immigrant human epidemiology Schools Asia ethnic group controlled study Time Factors screening school child Adolescent male England female heaf test prevention diagnosis tuberculin test ethnic or racial aspects normal human Emigration and Immigration monitoring Child