The Health bulletin [serial] - University of North Carolina at Chapel Hill

8 The Health Bulletin July, 1951mass x-ray survey just completed in thecounty.When we finally folded our tents andprepared to leave the battlefield a fewdays ago, approximately 24,500 citizenshad been x-rayed with 70 mm films,representing an increase of seventeenper cent over the mass x-ray survey of1946. (The total increase in populationduring the past decade in Halifax Countywas only 31,2 per cent.) This x-raytotal represents sixty-four per cent ofthe total x-ray population in the countyas compared to the fifty-eight per centtake in the previous survey; however,using the more reasonable goal as followedby the United State Public HealthService of taking eighty per cent ofthe population fifteen years of age andolder as a hundred per cent goal, we arrivedat a more favorable figure ofeighty per cent x-rayed. Russell Pierce(3)at the 46th Armual Meeting of the NationalTuberculosis Association in April,1950, as a result of an analysis ofeleven mass surveys which the UnitedStates Public Health Service had conducted,reported that these x-ray takesranged from sixty-nine per cent to 118.7per cent of the total x-ray population.Our take in Halifax County then for1951 would fall in the neighborhood ofthe median for these eleven mass surveysreported.Since we worked so hard in stressingthe four epidemiological factors duringthe organizational and educationalphases of the mass survey, it will beinteresting, even though disappointingto us, to report our results in this respect.In 1946 (Table 4), the numberx-rayed under forty-five years of agewas seventy-seven per cent and in 1951was seventy-six per cent of the total,while the age group forty-five years andolder represented twenty-three per centof the total in 1946 and only one per centbetter in 1951 with twenty-four per cent.The sixty-five years of age and oldergroup in 1946 constituted three per centof the total while in 1951 was four percent. Although percentage-wise, this oneper cent increase looks very anemic, theactual increase in numbers x-rayed inthis stubborn age group sixty-five yearsof age and older was 365.The racial breakdown (Table 5) ofthe total number x-rayed with 70 mmfilms was fifty-three per cent white in1946 and fifty-five per cent in 1951, comparedwith forty-seven per cent fornegroes in 1946 and forty-five per centfor negroes in 1951. Again, it appears inthis mass x-ray survey that om: extraefforts to get a larger percentage ofnegroes x-rayed was somewhat in vain.The total number of hospital cases(Table 6) discovered in the recent x-raystudy was fifteen, including fourteencolored and one white, compared with atotal of twenty for the mass survey in1946, including fifteen negro and fivewhite. The 1951 survey produced a discoveryrate of .6 per thousand citizensx-rayed compared with .9 per thousandin 1946 and 1.8 per thousand in theepidemiological survey in 1950.Nine of the fifteen hospital cases werecontacts from tuberculous families.Some of these contacts reported to thex-ray buses, after having refused to beexamined in our regular fiuoroscopicclinic for years. It is interesting to note,too, that four of the fifteen cases werefrom Enfield which again gave this areathe highest discovery rate.Only one of the fifteen cases was aschool child discovered through routineexamination of school children overfifteen years of age. One of the caseswas a child, age 12, who came in as acontact of a recently discovered case ofactive tuberculosis, and as a result of awritten notice from the health departmentto report for x-ray.The lone white hospital case discoveredwas a male, textile employee, overforty-five years of age, while thirteenof the fourteen negroes were from rural,agricultural areas. Of the negroes, ninewere imder forty-five, and five were overforty-five years of age.The provisional data (14 x 17 films)(Table 7) of this recent mass x-ray surveyrevealed a decrease in the numberof males found to have definite tuberculosisin the age group imder forty-five,with an appreciable increase fromthirty-five per cent in 1946 to fortysevenper cent in 1951 in the forty-five