TUBERCULOSIS mortality in Finland.

The present report, analysing the official statistics on tuberculosis mortality in Finland during the past 75 years, was undertaken to provide a background for studying the course of tuberculosis after the nation-wide BCG vaccination campaign of 1948-49.TUBERCULOSIS MORTALITY IN FINLAND HAS BEEN HIGH COMPARED WITH OTHER EUROPEAN COUNTRIES: before the end of the first World War the death-rate from respiratory tuberculosis fluctuated between 250 and 300 per 100,000; by 1953 it had dropped to 56 for males and 27 for females.Age-specific death-rates for respiratory tuberculosis usually showed peaks for infancy, young adulthood, and old age. For many years the highest mortality-rates for females were in young adulthood, and a high proportion of all deaths from respiratory tuberculosis, in both males and females, was in the age-group 15-40 years. Tuberculosis proportionate mortality was also high in this age-group: 30%-50% for males and 40%-60% for females. In recent years the pattern has changed, the "weight" in the age distribution of the number of deaths has shifted towards higher ages.The death-rates for non-respiratory tuberculosis, with tuberculous meningitis the most important, are several times higher in infancy than the rates for respiratory tuberculosis. Non-respiratory tuberculosis is of little importance in adults.The cohort curves for respiratory tuberculosis differ in two important ways from the classic curves for Massachusetts. The peaks of the Finnish curves in adult ages shift to lower ages with each succeeding cohort, and the curves often cross each other.Tuberculosis mortality in Finland, as in almost every other country, has decreased very rapidly since the second World War, particularly in the younger age-groups. However, as a similar pattern is found in countries where BCG has not been used, there seems to be little compelling evidence to support a belief that the nation-wide BCG programme caused much, if any, of the recent precipitous drop in mortality-rates. Other factors having a strong influence on tuberculosis mortality have undoubtedly been operating in Finland as almost everywhere.