| A Study on Case finding pro-gramme of Positive cases Bacteriologically by Sputum Examination in Urban Areas |
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Sung Kwan Lee |
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Department of Preventlve Medicine, School of Medicine, Kyongpook National University, Daegu, Korea |
| 도시주민에 있어서 담검사를 통한 결핵균 양성자 색출에 관한 연구 |
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이성관 |
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| Abstract |
Under the auspices of Tuberculosis Association of Korea sputum test for tuberculosis was made in、
Taegu City. The findings of this study are summarized as follows:
Examinees
1) Sputum collection was made in the slum areas of Taegu City. It was possible to collect sputum from 20,191 persons, and this represents 47. 5% of the estimated total of those aged 20 years and above in the areas.
2) Total number of out-patients who visited five health centers in Taegu City during the year of 1968
was 3,463. Among them 1,810 patients ( 52.2%) were examined.
Method
Comparing two examination methods detection rate was 100% both in concentration method anæ smear above the level of Gaffky 4. Below the level of Gaffky 3 detection rate in smear was lower than concentration method. Therefore the test was made by concentration method.
Detection Rate: Positive rate of tubercle bacilli in sputum
1) A total of 419 cases were discovered as a result of one microscopic examination with concentration method. Thus, the overall discovery rate was 1. 90%.
Positive rate of tubercle bacilli in sputum collected by home visiting only was 1. 70%.
2) The discovery rate was higher among the family contacts of tuberculosis cases registered at the health centres than among the families without registered cases, 5.52% and 1. 25%, respectively.
3) A total of 3,463 patients from these areas attended the health centres for various reasons. Sputum was collected from 1, 810 of them, or 52. 2% . and as a result of examination, 76 cases were discovred,
a discovery rate of 4. 19%.
4) When the total of 20, 191 persons examined are classified according to the presenCf: or absence of symptoms, and following different positive rates are obtained:
Symptome:Absence:Presence; Cough:0.52:6.17; Chest pain:0.63:8.63; Lose of weight:1.14:8.75; Bloody sputum:1.30:12.48
Cough, chest pain and loss of body weight (B.W.) - 12.20, Cough, blooy sputum, and loss of body W. - 14.73 , Bloody sputum, chest pain, and loss of B. W. - 17.40, Cough, blooy sputum, and chest pain - 30.00, Cough, bloody sputum, chest pain, and loss of B. W. - 47.30
Classification by NT A of those patients who were detected in sputum examination:
minimal 17.2%, MA 48.0, FA 34.8
Thirty percent out of them are either already known as tuberculous patients or have previously been registered once at the health center.
The cost of discovery per case differs according to the way of sputum collection as follows:
1) Home-visits by sputum collectors to non-tuberculous families: ￦ 2,,353
2) Home visits by sputum collectors to tuberculous families: ￦ 1, 268
3) Out-patient clinics: ￦ 1, 191
4) Cellection by staff of health centers or dong offices during extra-office hours: ￦2, 353
5) Collection by volunteers in the same dongs: ￦2, 800
6) Respondents with symptoms:
A. In the case of respondents who complained chronic cough cost needed for detecting one positive patient was 904 Won. ( $3.3 )
B. In the case of respondents with chest pain cost needed was 800 Won. ($ 3. 0)
C. In the cases of respondents with loss of weight cost needed was 921 Won. ($ 3. 4)
D. In the cases of respondents with bloody sputum cost needed was 1,239 Won. ($4.6)
Capability of Sputum Collectors:
A. Home visitors collected sputum of 500 cases a month.
B. Personnels in Dong office and health center collected sputum of 200 cases during their off time.
C. Working capability of the influencial personnels is ineffectient comparing to home visitors.
D. Students of aide nurses collected sputum of some 200 cases a month.
E. Number of cases by various symptoms:
i ) In the case of person with chronic cough 260 cases were collected a month.
ii) In the case of person with chest pain 210 cases were collected a month.
iii) In the case of person with loss of weight 180 cases were collected a month.
iv) In the case of person with bloody sputum 90 cases were collected a month
Working Capability of Microscopic Technician 500 cases per month were examined by the technician. |
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