Tuberculosis in young generation: a report from six general hospitals

Abstract

We investigated epidemiologic and clinical aspects of tuberculosis in young generation and pointed out problems in ambulatory treatment. In six general hospitals in Tokyo, 418 cases of tuberculosis (285 males and 133 females) were diagnosed between 1983 and 1991. They were divided into three groups; 1) young group, 10 to 29 yr (62 cases), 2) middle age group, 30 to 69 yr (255 cases), 3) elderly group, above 70 yr (101 cases). And the risk of clinical breakdown, method of case finding, radiological findings, extra-pulmonary lesions, method of diagnosis, relationship with epidemics, patient's delay, doctor's delay, drug regimens and patient's compliance in each group were investigated. In addition, after completion of therapy we sent them survey questions about relapse and attack of tuberculosis among their families. Results were followings. 1) Estimated risk of clinical breakdown by age was calculated as follows, (the number of patients)/(the population of Tokyo)/(estimated incidence of infection). This was extremely high in young group. 2) Sixteen percent of patients in young group were related with epidemics and another eight percent with familial outbreaks. 3) Although many patients in young group showed focal lesions in chest radiographies, the rate of symptomatic patients was 61% and that was almost same as in other groups. 4) The rate of patients showing atypical radiographic findings, extra-thoracic lymphadenopathy and idiopathic pleuritis were relatively high in young and elderly group. 5) Results of survey questions showed no relapse among ambulatory treated patients. Familial outbreaks (three cases) were thought to be caused by long patient's delay and not by ambulatory treatment of smear-positive patients.(ABSTRACT TRUNCATED AT 250 WORDS)