| A Bacteriological and Radiological Survey of Tuberculosis Patients Registered in 4 Health Centers in Korea |
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Sung Chin Kim1, Sang Jae Kim1, Kyu Jung Lee1, Dal Ho Song1, Heai Won Pyun2, Kee Yong Lee3, Yong Dal Shin4 |
1The lnstitute of Tuberculosis, KNTA
2Department of Internal Medicine, Catholic Medical College, Seoul, Korea
3Department of Internal Medicine, EWha Womens Medical College, Seoul, Korea
4TB Prevention Section, Ministryof health and social affaires |
| 보건소 등록 결핵환자의 임상경과와 항결핵제에 대한 내성에 관한 조사연구 |
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김성진1, 김상재1, 이규정1, 송달호1, 변해원2, 이기용3, 신용달4 |
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| Abstract |
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In order to discover the status of T.B. patients registered in Korea, 4 urban and rural health centers
were selected as a representative cross section for a study done in April, 197 1. At these 4 health - centers there were 3,245 registered patients, amongwhich 1, 607 were randomly selected for the study. Of these 1, 607 patients who were eligible for examination 1, 038 were actually examined by chest X -Ray and sputum smear and culture for tubercle bacilli. Those who were sputum culture positive for tubercle bacilli also received a drug sensitivity test. There werè 276 bacteriologically positive cases. In April, 1972 all those who were positive in 1971 and still available for examination (205) were followed up by X- Ray and' sputum smear and culture examination . The following characteristics were analysed in the cross section of T.B. patïent in 1971: The percent of patient positives at the time of study; the conversion rate from time registration to time of study öf those registered as positive; the drug sensitivity pattern of those positive on culture at time of study; the pattern of X-ray findings at time of study. ln 1972 when the positive cases were followed up, the following characteristics were analysed: the percent still positive after an additional year of treatnent; the pattern of X-ray changes after an additional year treatment correlated with bacteriological status; the reàson for discharge for those who were discharged (moved, dropped out, died etc.). Summary of Results Status of patients in 1971:
1. Rate of bacteriologically proven cases was 28.7% of total number of registered patients.
2. The breakdown of patients as determined by length of registration was : a) more than 1 year-73.0% , b) more than 2 years -50.1%.
3. Rate of bacteriologically proven cases among those who were registered more than 2 years was 38.0%.
4. Rate of bacteriologically positive at time of registration was 48.7% . Among these patients 62.3% had converted to sputum negative by the time of the study (less than 1 year treatment).
5. Among the 276 positive patients in 1971, 205 were fo11owed up in 1972. The positive rate was .83.9%. The reason for 71 (25.7%) patients not available for examination was broken as follows; 12(4.3%) cured; 25 (9.1%) died; 14(5 . 1%) moved out; 12(4. 3% ) dropped out; 8( 2.9% ) unknown.
6. Among those who were still positive on culture at time of study in 1971 90.6% had resistance to 1 or more of of the standard drugs (INH, PAS and SM). This is 21. 1% of the total number of registered patients.
7. Analysis of drug sensitivity pattern of those positive on culture showed; 37.7% were re sistant
to all drugs 34.1% were resistant to 2 drugs; 18.9% were resistant to a sin~le drug. Most patients showed resistant to the drugs in high condentration, especially INH.
8. Among those who were sensitive to all 3 drugs in 1971 and remained culture positive in 1972, 90.9% had become resistant to 1 or more drugs. Among those resistant to 1 drug in 1971, 40.0% showed resistance to 2 or 3 drugs in 1972. Among those resistant to 2 drugs in 197 1, 45.2% showed resistance to 3 drugs in 1972. Among those resistant to 3 drugs in 1971, 26.9% showed resistance to only 1 or 2 drugs in 1972.
9. Among those who had converted from sputum positive in 1971 to sputum negative in 1972, 63.2% showed no change, 31. 6% improved and 5. 3% showed deterioration on X-ray finding. Among those who were positive in 1971 and 1972, 68.9% showed no change, 2.8% improved and 28.3% showed deterioration on X- ray finding .
10. Among those resistant to 1 drug, 2 drugs or 3 drugs, 20.0% , 11. 5%, 6.3% respectively showed sputum negative conversion in 1972.
11. The drug sensitivity tests showed comparatively very low resistance to secondary drugs.
12. Analysis of longstanding patients registered more than two. years showed 58.5 % should be
discharged as completely treatment. 21. 7% were initia11y sputum negative and remained negative for more than 2 years, 36.7% were initia11y sputum positive but had converted to sputum negative .after more than 2 years treatment . |
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