Microscopy of Ziehl-Neelsen stained smear of laryngeal swats and sputum specimens Produced 73 Positives from 1,815 radiological suspects screened out of 23,319 inhabitants acted 5 years or more in 123 sample areas selected by multi-stage stratified systematic sampling in the 4th nation-wide tuberculosis prevalence survey-1980. Culture examination of the specimens by oxalic arid method (OA) yielded 119 positives and sputum culture by sodium hydroxide treated simple culture method (55) produced 156 positives, indicating the latter method was superior over the former. Total positives found by the various methods were 184 cases of which larger number of positives and heavier excretors were usually found in the more radiologically severe cases in terms of disease extent. One case of nontuberculous pulmonary infection due to M. avium-intracellulare complex was also found whose bacilli failed to grow on primary OA culture. Forty eight per cent of M. tuberculosis from 177 patients showed resistance to one or more anti-tuberculous drugs and 30.6% of resistant cases were also found from 108 patients having no history of previous chemotherapy. Resistances to INH, PAS, SM, EMB, and RMP were 43.5%, 16.9%, 15.3%, 13.0%, and 1.7% respectively. Statistically significant increase of INH and EMB resistances, when compared with those of 1965 and 1975 surveys respectively, was probably due to big hike of drug use. Initial drug resistances to INH, PAS, SM, and EMB were 25.0%, 6.5%, 5.6%, and 5.6% respectively. While EMB resistance again increased significantly, SM resistance, on the contrary, was in decreasing trend. No statistically significant difference of drug resistance was recognized between male and female and between urban and rural patients, however, initial drug resistance of urban patients (44.9%) was significantly higher than that of rural patients (18.6%). Initial drug resistance of rural female patients (15.0%) was significantly lower than that of urban female patients (50.0%). Resistance to one, two, three, and four or more drugs were 22.6%, 10.7%, 6.2%, and 9.5%, showing multiple drug resistance to four or more drugs significantly increased when compared with that of 1975 survey. Resistances to INH, PAS, and SM in patients who had used corresponding drugs previously, were 73.5%, 51.5%, and 33.3% respectively. Resistance to 5 mcg/㎖ of INH
in patients with history of previous chemotheraphy of this drug gradually increased from 1970 survey. High incidence of drug reisistance mainly due to wide and improper use of drugs urges to improve treatment services.
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