結核
Online ISSN : 1884-2410
Print ISSN : 0022-9776
ISSN-L : 0022-9776
モンゴルにおける結核統計の年次推移と都市部での最近の登録結核患者の検討
豊田 誠
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ジャーナル フリー

1998 年 73 巻 7 号 p. 477-483

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Recent Mongolian political, social and economic changes have had a great impact onits health care system and tuberculosis control program. The objective of this study is toassess time trend in incidence and mortality of tuberculosis and characteristics of notifiedtuberculosis cases in Mongolia.
1) Data on statistics of tuberculosis are obtained from reports of the National Tuberculosis Center in Mongolia. The mortality of tuberculosis in Mongolia shows a downward. trend during 1985-1995. The number of notified tuberculosis cases had gradually decreasedduring 1985-1989. It suddenly dropped in 1990 and was the lowest in 1993. Afterthat, about two fold increase in the notified cases was observed in recent three yearsfrom 1993 to 1995. Such a large fluctuation in the number of notified cases after 1990 isunlikely to be associated with the epidemiologic situation of tuberculosis, but rather dueto a reporting bias. The shortage of drugs and economic hardship prevented patientsfrom consulting medical facilities. The shortage of drugs also prevented doctors from notifyingpatients to the tuberculosis registry, because the notification did not lead totreating the disease. The improvement of health care system and the supply of essentialdrugs since 1994 seems to contribute to the increase in the number of notified cases.
2) The study subjects include 618 patients who were diagnosed as active tuberculosis atten tuberculosis specialized facilities in Ulaanbaatar, Mongolia from May 1995 to March1996. Patients were interviewed about their demographic factors and their medicalrecords were reviewed. Fifty one percent of the cases were female. The mean age was 26.9years old. Ninety percent of the cases underwent chest X-ray examination, while 72% ofthe cases underwent bacteriological examination and only 21% were confirmed bacteriologically.
It is necessary to improve the quality control of sputum smear examinationand the validity of diagnosis of tuberculosis in Mongolia. As for teratment regimens, only 29% of the cases were being treated with at least four drugs (isoniazid, rifampicin, pyrazinamide, ethambutol and/or streptomycin). It is needed to provide directly observedtreatment using the WHO recommended standard regimen to at least smear positive tuberculosiscases.

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