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KMID : 0383819630100020007
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Tuberculosis and Respiratory Diseases
1963 Volume.10 No. 2 p.7 ~ p.28
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A Study of the Tuberculosis-Infection Rate-Morbidity and -Mortality in a Pilot Area(Ya Hyun Dong) in Choong Koo, Seoul
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E.Refsum/Erling Refsum
DongPillKim/Dong Pil Kim
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Abstract
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Summary
This report cover a mass survey, including tuberculin testing and photofluorography,
of the population in a Pilot Area(Ya Hyun Dong) in Seoul, and further analysis of the
tuberculosis morbidity and mortality in the same area. 4786 persons attended the mass
survey, i.e. 78.6% of the population. Above 20 years of age the response was much
better from women than men. Altogether 1034(21.6%) were recalled for further
examination and of these about 20% failed to attend, We succeeded, however in securing
control examination of, practically speaking, all persons whose photofluorogram had
shown changes which might be deemed indicative of a serious affection of the lungs.
Tuberculin testing was carried out with Mantoux test, 5 T.U.(table 3 and fig.2).In the
age group 0-4 years 19% of the males and 18% of the females showed positive
tuberculin reaction, and in the age group 5-9 years 45% and 47% respectively. From
20-29 years of age nearly 100% of the males and a somewhat lower percentage of the
females showed a positive tuberculin reactions according to size of induration is
presented in the form of histograms. Below the age of 50 years 93% of the males and
85% of the females, showing negative tuberculin reaction was BCG vaccinated.
Previously undetected infectious pulmonary tuberculosis was disclosed in 62 persons(36
M and 26 F). i.e. 1.3% of the total number examined((1.68% M and 0,96% F). The
highest percentage was found among men between 20 and 50years of age(table 5 and
fig. 5). Of previously undetected cases of non-infectious. pulmonary tuberculosis the
masts survey revealed 162(87 M. and 75 F.), i.e.3.38% of those examined(4% .M. and
2.84% F) table 5. Among persons who were realled and also attended for further
ex-amination active pulmonary tuberculous diseased (infections + non-infectious)was
disclosed in 27%(M3O.5% and F-23.5%). Paragonimiasis was found By
polo-tofluorog-raphy in 0.48%(0.67% M. and 0.3% F.). A general account of the central
register for tuberculosis for the pilot area as of 1962 is given in table 7. At the end of
the year 264 patients(60% M. and 40% F) were registered. The percentage of infectious
cases(M+F)was 36% and non-infectious cases 64%. Of infectious cases 70% and were
men of 30% women(table 8). Of the whole population 4.3% was registered as suffering
from tuberculous disease(1.56% infectious and 2.77% non-infectious). Most of the new
confirmed cases were found through mass survey, but this was only attended by
approximately 80% of the population. A calculation of the morbidity among absentees
has been attempted. Of the confirmed 183 cases(100 M and 83F)49 cases load infectious
and 91 non-infectious tuberculosis of the lungs. 35 had hilar adenitis, 3 pleurisy, 1
meningitis, 1 acute miliary from,1 bone-joint disease and 2 lymphnodes of the neck. We
suspect that hospitals and practitioners often forget to refer cases for registration at the
Health Center. The extent or the pulmonary lesion among the new confirmed 179 cases
of pulmonary tuberculosis showed: minimal 68.7%, moderate 19.5% and far advanced
11.8%. Tubercle bacilli were demonstrated in 45 cases. Six persons(3 M and 3 F) died
from tuberculosis(table 12). Of these, 3 had not been registered before. The motality per
1000 of the population was 1(M 1.03 and F 0.94), 175 patients receive anti-tuberculous
drug treatment with 2 or 3 drugs and 31 children received chemoprophylaxis. In our
opinion 22 cases of the 225 patients registered for pulmonary tuberculosis at the end of
1962 were considered intractable for effective treatment, i.e. 9.8% of all registered cases
and 23.2% of the registered infectious cases. Drug susceptibility tests showed that
aniongst 39 new confirmed cases of bacillary pulmonary tuberculosis. previously not
treated with anti-tuberculous drugs, in 3 cases the bacilli were demonstrated to be
resistant to INH and in 2 cases to PAS From all 90 patients on the T.B,C. register with
bacillary Pulm. tuberculosis the bacilli were demonstrated resistant to all 3 main drugs
in 2%, resistant to 2 drugs in 9% and resistant to one drug in 21%(tables 13-18). Of
the 1329 household contacts were 86.4% examined, Tuberculous disease was uncovered
in 6.7%(M 8.4% and F 5.2%). A valuation of the tuberculosis work in the pilot area is
given.
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KEYWORD
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