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KMID : 0351619720130020197
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Kyungpook Medical Journal
1972 Volume.13 No. 2 p.197 ~ p.215
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Studies on Various Factors Affecting Tuberculosis Control and Treatment of Ambulatory Patients Registered at Health Centers
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Abstract
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The purpose of this study vas to obtain available data concerning the attitude of ambulatory patients registered at health cente,~s on the tuberculosis control, the management of patients by participants of health center, analysis of various factors effecting antituberculosis treatment and the causes of interruption of chemotherapy. This study was conducted from March 1970 to February 1971.
Materials and method:
One thousand three hundred and fifty-four patients registered at three .health centers in Taegu City were randomly selected for collection of data about the attitude of patients concerning tuberculosis control and management by the health center´s officers. Eight hundred and twenty-six patients, for analysis of various influential factors in relation to efficacy of treatment, and 562 patiehts discharged during the past one year, for analysis of the causes of discontinued chemotherapy were selected,.
1. Attitude of patients about tubercui´.osis control and management by health center´s officers.
Patients´ attitude:.
The majority of the patients(95%) lived in poor economic conditions and 51 percent had families to support. There was high risk of infection for their family because they aII lived in the same room(64~,) and because of careless disposal of sputum(30~). Contacts examination for early detection of disease among families was as low as 40 percent. More than fortypercent of patients had to work to support their families as hard as healthy persons. Most of the patients conducted normal marital lives and 39 percent of the patients had experienced a pregnancy during the illness. Fifty-five percent of the patients were registered late more than one month after the diagnosis of the disease. By the time of registration, 66 percent of patients had never been treated and among treated cases, 61 percent took their medicine irregularly.
Management of health center:
Inadequate drug regimen at the time of registration by health officers was up to 32 percent and the rate of irregular drug collection was 6 percent. Irregular examination of sputum and X-ray turn out to be 48 and 16 percent, respectively.
2. Results(sputum negative conversion and X-ray improvement) of treatment by socioeconomical factors of patients and various factors concerning tuberculosis control and.management.
There were no differences of results between males and females. By age, those younger showed more favorable results than those older patients. There -as proportional tendency between efficacy of treatment and living standard. The main causes of the failure of the treatment were that treatment began late in the course of the disease, unsupervised treatment before registered at health center, heavy-work which lead to fatigue, thoughtless marital life and pregnancy, inadequate drug regimen at health center and irregular ~~ollection of drugs.
3. Drug resistance.
Emergency of drug resistance:
The rate of resistance at minimal inhibitory concentration of drugs was 87.5 percent among patients who took the medicine for more than 6 months period. The emergency of drug resistance was closely related to the eYpe~~ience of previous treatment conducted irregularly and inadequate regimen at health center a,zd irregular collection of drug. According to ttegree of resistance, the slight resistant group revealed favorable results as well as the sensitive group while the moderate and high resistant grouphad unfavorable results.
4. Status of discharge.
Forty-nine percent of patients discharged were treated completely but this does not imply complete healing. Among defaulters(interruption of treatment) fifty percent of them could not be reasonable discharged. The status of sputum and X-ray finding at the time of discharge concluding complete treatment, revealed 51 per-cent sputum positive and 53 percent active lesions in X-ray finding of patients, namely more than fifty percent of patients were discharged as infectious cases.
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