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KMID : 0383819700170020015
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Tuberculosis and Respiratory Diseases
1970 Volume.17 No. 2 p.15 ~ p.26
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Reasons for Defaulting Domiciliary TB Treatment. A Study done on Patients of a General Hospital Serving the Rural District around Wonju, Korea
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EverettLanden/Everett Landen
GeorgeCauthen/吳尙伯/George Couthen/Sang Baik Oh
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Abstract
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A clinical and sociomedical study was made of 112 domiciliary TB patients who had
defaulted treatment and of 88 who were continuing treatment (control group) at the
Chest Clinic of the Wonju Christian Hospital which serves the rural district around
Wonju City. From the data which was gathered in 1968, the study concludes the
following about defaulting.
1) ⓐ By initial diagnosis of extent of disease, far advanced pulmonary TB was
predominent in the defaulter group. Moderately advanced and far advanced TB were
predominant in the control group. Children with pulmonary and extra-pulmonary TB
were relatively many in the control group.
ⓑ By positive rate of TB bacilli in sputum, no marked difference between defaulters
and controls.
ⓒ 69% of the defaulter group had a duration of illness less than 24 months (29.5%
under 12 months and 39.3% between 12 and 24 months), but 41% of the controls was in
this category (14.7 and 26.1% respectively). 13.4% of defaulters were rather chronic
cases (duration of illness more than 48 months) compared lo 32.9% of the controls.
ⓓ Most defaulters (51.6%) had collected drugs for a duration of less than 6 months
when they discontinued treatment at the Chest Clinic. However, predominantly more of
the controls (40.9%) fell into the 7∼12 months category at the time of the study.
ⓔ By drug regimen, two and three drug combinations predominated in the
defaulters(49 and 49. 1%), whereas 64.7% among controls were receiving a two drug
combination.
ⓕ In clinical change no remarkable difference was seen between defaulters and
controls.
ⓖ Out of seven occupational groups, the farmer-laborer category in tile defaulter
group and the unemployed in the control group were of the largest number at about a
one third proportion each. Merchants, infants and children were relatively more among
the controls.
ⓗ For three categories of the distance of residence from the Chest Clinic, numbers of
defaulters divided into 13.54 and 45 from near to far. Controls divided into 37, 20 and
13.
2) On the eleven items questionaire sent out to determine reasons far defaulting,
answers were as follows: ⓐ Moved resident-7.0%. ⓑ Registered at goverment health
center-29.9%. ⓒ Treatment at other hospital-4.4%. ⓓ Drugs bought at pharmacy-19.2%.
Here, ⓑ, ⓒ, and ⓓ are continuing treatment at another souse-53.5% in all. ⓔ No
symptoms-2.5%. ⓕ Cured at another hospital-0.6%. ⓖ Doesn't like medicine-3.2%.
Here,8, ⓒ, and ⓖ are thought to be fundamentally by carelessness and
indifference-6.3% in all. ⓗ Thinks no hope-2.5%. ① Too far to hospital-10.8%. ⓙ
Inconvenient to come to hospital-6.4%. ⓚ No money-13.4%. Here, ⓗ,ⓘ,ⓙ, and ⓚ are
fundamentally by economic difficulty-33. 1% in all.
3) Taken as factors, duration of illness, duration of drug collection, occupation, and
distance of residence appeared to have correlation with the reasons for defaulting, while
initial diagnosis of disease or clinical changes did not.
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