The tuberculin reaction in patients of the Fiji leprosy hospital.

Tuberculosis has long been, and still remains, an important if subsidiary complication of leprosy in this institution. Beginning in 1947-1948 (1), and continued more recently, the inmate population was subjected to tuberculin testing. Having received an inquiry about the results of that work (3), I present the findings here in summary form. The reports from this hospital show that such an investigation was made here by Hall in 1917 (2). He applied the von Pirquet test to 121 patients and recorded 65.5 per cent positive reactions. Pointing out that a large proportion of all Fijians have tuberculous foci, active or inactive, he recalled that Harper, of the Fiji Medical Service, had tested by the same method 224 individuals of the general population and found 62.5 per cent of them positive. The high incidence of tuberculous infection was emphasized especially by the fact that Harper had found 22.7 per cent positives in children under five years of age. Hall himself had no young patients to test, who would have lowered somewhat the proportion of positives, but as it stands his figure is essentially the same as the one of Harper for the general population. In the work mentioned briefly in my 1948 report, 1,010 tests were made on 645 patients, comprising 229 Indians, 120 Fijians, 76 Gilbert Islanders, 57 Cook Islanders, 50 Samoans, and less than 20 each of several other groups-Solomon Islanders, Niue Islanders, Rotumans, Chinese and Euroesians. Altogether, positive results were obtained in 55.5 per cent of the patients, although as stated in that report only 34.1 per cent of the total tests made resulted in positive reactions. There were 86 schoolchildren of whom 38, or 44.2 per cent, were found positive; of the 559 adults 307, or 54.9 per cent, were positive. The tuberculin used was of the OT type. The dosage varied, and because of shortage of material the testing could not be continued in the negatives to the normal 1: 100 maximum dose except in a few cases. Most of the patients (550) were started with a 1 :10,000 dilution, to which 119 (21.6%) reacted. On