1991 Volume 66 Issue 10 Pages 661-669
Using the registration card of tuberculosis patient, a retrospective analysis was made on newly registered 379 patients with pulmonary tuberculosis in 1985 to examine the treatment duration, the outcome, the duration of registration, and bacteriological relapse. These patients were divided into three groups according to the results of bacteriological examination at the time of registration: (1) patients with positive-bacilli (Group A) (2) patients with negative-bacilli (Group B) and (3) patients without results of bacteriological examination (Group C).
1) Number of cases were 164 (43.3%) in the group A, 130 (34.3%) in the group B, and 85 (22.4%) in the group C. Sputum specimens from 68 patients (80.0%) of the group C were negative on smear, however, the results of culture were not obtained, and remaining 17 cases (20.0%) were not examined bacteriologically.
2) 54 patients (32.9%) in the group A, 25 (19.2%) in the group B, and 17 (20.0%) had a previous history of tuberculosis, respectively.
3) Number of patients with cavitary lesions at the time of registration were 105 (64.0%) in the group A, 46 (35.4%) in the group B, and 14 (16.5%) in the group C. Patients in the group A showed the highest rate of cavitary lesions.
4) Number of patients receiving treatment less than 12 months were 73 (53.3%) in the group A, 92 (85.2%) in the group B, and 47 (73.5%) in the group C, respectively.
5) 317 patients (83.6%) were omitted during 5 years of period from registration although 62 (16.4%) were still under registration even after 5 years. Out of 317 patients omitted from the registration, 197 (52.0%) were omitted because of cure, 24 (6.3%) change in diagnosis, 34 (9.0%) transfer out, and 62 (16.4%) death. There were noticeably high rates of death within a year and alteration of diagnosis in the groups B and C compared than in the group A. Comparing with patients in groups B and C, however, patients in the group A most frequently died of tuberculosis (6.3%).
6) Proportion of patients with no-tuberculous diseases was estimated at about 10% of the patients registered, and these patients were frequently seen in the groups B and C.
7) Of the 18 patients who were retreated after the completion of original chemotherapy, positive cultures were obtained only in four patients. These four patients corresponded to 1.5% of the 259 patients who completed follow-up after the completion of chemotherapy. When the analysis was confined to patients treated for 6- to 13-month, the relapse rate was 1.3% of the 170 patients.
The data obtained here indicates the importance of the supervision of tuberculosis patients to accurately collect the results of the bacteriological examinations not only at the time of registration but also at the time of beginning of retreatment. As considerable number of patients with negative-culture or no bacterial examination who were listed as tuberculosis assumed to be non-tuberculous diseases, we should make every efforts to eliminate the false diagnosis to save our work in the control of tuberculosis. At the same time, sputum smear positive cases should be given top priority in case-holding.
