B.C.G. scar surveys in Enga province: A medical anthropology note

BCG vaccination of both children and adults has a high priority in the tuberculosis campaign in the Papua New Guinea Highlands. It is increasingly recognized that the BCG scar survey is simple and a more accurate means of determining age-specific population coverage than are reports on numbers of vaccinations given. In Enga Province, BCG scar surveys have been conducted simultaneously with other field programmes since 1974. It had been the custom in Enga, as in other provinces, to give BCG on the left deltoid region. However it was noted that in Enga Province a large number of people of adolescent age and older had great numbers of shoulder scars which could not be attributed to, but were indistinguishable from, BCG vaccination. As a result of this a new anatomic site for BCG vaccination was chosen. Since 1975 BCG vaccination has been given on the middle third of the volar surface of the left forearm. At this site there are not competing decorative marks and the resultant scar is easily exposed during surveys.