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Much more informative than a point
estimate of the risk of infection is the secular trend in the annual
risk of infection. If serial tuberculin surveys are available,
then such trends can be calculated. The risk
of infection was very large in Europe 100 years ago, it was in the order
of magnitude of 10%. It declined rapidly. The average annual
decline may have been around 5% before the introduction of chemotherapy
and 10% and more thereafter. It may be noted
that for instance the epidemiology of tuberculous infection in France from
these estimates lags about 15 years behind the Netherlands. Over the
time frame relevant in tuberculosis epidemiology this is, however, not of
much importance. If the trend has continued, France is now at
similarly or even lower level than the Netherlands in 1980. The slope
parameter of decline is of more importance than the intercept
parameter over a sufficiently long period of time. To
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