A follow-up study was made for those pulmonary tuberculosis patients who were radiologically identified during the Nationwide Pulmonary Tuberculosis Prevalence Survey in 1980 in order to study the treatment behavior of pulmonary tuberculosis patients and changes in disease after the elapsing of a certain period. The relationship between the two variables was analyzed. The field study was made in August and September 1982 and major findings were as follows.
1. A total of 365 patients (70.5%) received treatment and 153 patients(29.5%) received no treatment among those 518 patients who were follow-up studied. Only 32 percent were treated among the age group under 19 years and the rate for those receiving treatment increased between 20 to 59 years and then dropped again, that is, reversely U-shaped. Treatment rate was higher among males, and there was no significant difference by residential area. Meanwhile, the high income group, and those severely ill showed higher treatment rate and only 37.6% of thoses with minimal tuberculosis received treatment. A total of 40.5% among those not treated replied that they did not get treatment because they had no symptom.
2. A total of 76.2% was treated at health center, 10.4% at hospital or clinic, and 12.1% at drug store respectively. The health center was the most important institution for tuberculosis treatment and the drug store also plays a certain role for treatment. A total of 95.5% of the farmers received treatment at health centers and the importance of health centers was recognized in rural area. The more educated and the higher the income, the lower the rate of utilizing health centers.
3. Both X-ray finding and sputum test results were assessed during the two-year period. A total of 68.4% were cured, 6.5% dead and 25.1% were still ill. Treatment rate of female was lower than male, however, cure rate was higher among female at 76.6% than in male, 63.8%. The cure rate was higher under 19 years old at 95.9% and the rate was linearly decreased by age. The cure rate wart higher among the educated and higher income group, however, there was no significant difference by residential area. Those who were sputum negative and mild cases in 1980 showed a higher cure rate.
4. A total of 67.3% was cured among the treated group and 71.7% among the non-treated group although there was no statistical significance. However, those who were treated regularly showed a higher cure rate of 74.1%, and those not regularly treated showed a 56.7% cure rate, which is statistically significant. The cure rate was highest at 73.2% when the treatment period was in the 13∼24 months group, and the longer the treatment period, the worse the result of treatment.
5. Changes in sputum test results between 1980 and 1982 were analysed. Conversion rate was 69.9% or 72 cartes out of 103 sputum positive cases were converted into sputum negative, Meanwhile 31 (8.8%) cases out of 354 sputum negative cases converted into sputum positive. Sputum negative conversion rate was higher among female at 83.3% than male at 64.4% and the conversion rate was higher among the younger patients. The higher the income level, the higher the conversion rate tut there was no significant difference by residential area, When the X-ray finding was severe cases in 1980, the sputum negative conversion rate was lower.
6. The conversion rate was 71.6% among the treated group and 60.0% among the nontreated group. Those treated at hospital or clinic were converted into sputum negative 100.0% and 72.3% at health center, 42.0% at drug store respectively. Among those drug store users 15.2% of sputum negative cases in 1980 became sputum positive in 1982.
7. In summary personal characteristics such as sex, age, education, economic statue and residential area resealed major determinants for treatment behavior, such as seeking treatment, treating institution and regularity of treatment. In addition, two characteristics that is, personal characteristics and treatment behavior were revealed as major determinants for treating diseases.
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