Pulmonary Tuberculosis Mortality Research Articles

Trends in pulmonary tuberculosis mortality between 1985 and 2018: an observational analysis

BackgroundPulmonary tuberculosis (TB) is a major source of global morbidity and mortality. Latent infection has enabled it to spread to a quarter of the world's population. The late 1980s and early 1990s saw an increase in the number of TB cases related to the HIV epidemic, and the spread of multidrug-resistant TB. Few studies have reported pulmonary TB mortality trends. Our study reports and compares trends in pulmonary TB mortality.MethodsWe utilized the World Health Organization (WHO) mortality database from 1985 through 2018 to analyze TB mortality using the International Classification of Diseases-10 codes. Based on the availability and quality of data, we investigated 33 countries including two countries from the Americas; 28 countries from Europe; and 3 countries from the Western Pacific region. Mortality rates were dichotomized by sex. We computed age-standardized death rates per 100,000 population using the world standard population. Time trends were investigated using joinpoint regression analysis.ResultsWe observed a uniform decrease in mortality in all countries across the study period except the Republic of Moldova, which showed an increase in female mortality (+ 0.12 per 100,000 population). Among all countries, Lithuania had the greatest reduction in male mortality (-12) between 1993–2018, and Hungary had the greatest reduction in female mortality (-1.57) between 1985–2017. For males, Slovenia had the most rapid recent declining trend with an estimated annual percentage change (EAPC) of -47% (2003–2016), whereas Croatia showed the fastest increase (EAPC, + 25.0% [2015–2017]). For females, New Zealand had the most rapid declining trend (EAPC, -47.2% [1985–2015]), whereas Croatia showed a rapid increase (EAPC, + 24.9% [2014–2017]).ConclusionsPulmonary TB mortality is disproportionately higher among Central and Eastern European countries. This communicable disease cannot be eliminated from any one region without a global approach. Priority action areas include ensuring early diagnosis and successful treatment to the most vulnerable groups such as people of foreign origin from countries with a high burden of TB and incarcerated population. Incomplete reporting of TB-related epidemiological data to WHO excluded high-burden countries and limited our study to 33 countries only. Improvement in reporting is crucial to accurately identify changes in epidemiology, the effect of new treatments, and management approaches.

The Application of Artificial Intelligence in the Diagnosis and Drug Resistance Prediction of Pulmonary Tuberculosis.

With the increasing incidence and mortality of pulmonary tuberculosis, in addition to tough and controversial disease management, time-wasting and resource-limited conventional approaches to the diagnosis and differential diagnosis of tuberculosis are still awkward issues, especially in countries with high tuberculosis burden and backwardness. In the meantime, the climbing proportion of drug-resistant tuberculosis poses a significant hazard to public health. Thus, auxiliary diagnostic tools with higher efficiency and accuracy are urgently required. Artificial intelligence (AI), which is not new but has recently grown in popularity, provides researchers with opportunities and technical underpinnings to develop novel, precise, rapid, and automated implements for pulmonary tuberculosis care, including but not limited to tuberculosis detection. In this review, we aimed to introduce representative AI methods, focusing on deep learning and radiomics, followed by definite descriptions of the state-of-the-art AI models developed using medical images and genetic data to detect pulmonary tuberculosis, distinguish the infection from other pulmonary diseases, and identify drug resistance of tuberculosis, with the purpose of assisting physicians in deciding the appropriate therapeutic schedule in the early stage of the disease. We also enumerated the challenges in maximizing the impact of AI in this field such as generalization and clinical utility of the deep learning models.

Assessment and evaluation of the knowledge and attitude regarding pulmonary tuberculosis among Riyadh residents

Background: The incidence and mortality of pulmonary tuberculosis (PTB) are rising globally in the coronavirus disease (COVID-19) era due to resource allocation and the deviation of global attention toward the pandemic. Hence, this study aimed to assess and evaluate the current knowledge and attitude toward PTB among the residents in Riyadh. Methods: A cross-sectional study was conducted among Riyadh residents using a self-administered online questionnaire. The sample size was calculated as 385. A scoring system was developed to categorize the level of knowledge of PTB into poor, good, and excellent. The questionnaire also evaluated the attitude level. Results: Out of 759 participants, the male-female ratio was almost equal, and nearly 80% had a university education level. The participants' scores were 31%, 39%, and 30% for poor, good, and excellent knowledge regarding PTB, respectively. There were significant statistical associations between the score (p = 0.012), the ability to identify PTB signs and symptoms (p = 0.002), and age; and also between the level of education and PTB knowledge (p = 0.03). Conclusion: The overall level of knowledge was good, which could be attributed to age, level of education, and COVID-19 awareness campaigns. There was a lack of knowledge in essential PTB information with an insufficient attitude toward PTB patients. The public needs more positive enforcement and awareness of the disease's basic concepts. Further studies on less-educated groups and older adults are needed for better assessment.

Social determinants of pulmonary tuberculosis in Brazil: an ecological study

BackgroundSocial determinants may influence the incidence and control of tuberculosis (TB). The aim of this study was to evaluate the correlation between social determinants and pulmonary TB (PTB) incidence and treatment outcomes in different regions in Brazil.MethodsIn this ecological study, PTB incidence and treatment outcome rates as well as HIV incidence for all 5560 Brazilian cities as reported to the Brazilian Tuberculosis Program in 2010 were correlated with two social indicators, the Human Development Index (HDI) and Gini Index (GI). Cities were stratified into six groups based on location (metropolitan region or not) and size (small, medium, and large cities), and according to the regions of the country to which they belong. The Spearman correlation coefficient was used to assess the association between variables.ResultsIn 2010, 68,729 new PTB cases were reported in Brazil, with an incidence rate of 36 cases per 100,000 inhabitants. Incidence rates and PTB mortality demonstrated a weak negative correlation with HDI and a positive correlation with GI. The correlation between HDI and GI with cure, relapse, and lost to follow-up of treatment greatly varied in the different groups of cities and regions of the country evaluated.ConclusionsThere is a weak correlation between HDI and GI and PTB incidence and mortality rate. However, there is great variation between the HDI and GI and cure, relapse, and lost to follow-up in the different groups of cities and regions of the country. This suggests that for TB determination, these outcome variables might be more related to the quality of healthcare provided by services than to social determinants in the general population.

Was the First Public Health Campaign Successful?

The US tuberculosis (TB) movement pioneered many of the strategies of modern public health campaigns. Using newly transcribed mortality data at the municipal level for the period 1900–1917, we explore the effectiveness of public health measures championed by the TB movement, including the establishment of sanatoriums and open-air camps, prohibitions on public spitting and common cups, and requirements that local health officials be notified about TB cases. Our results suggest that these and other anti-TB measures can explain, at most, only a small portion of the overall decline in pulmonary TB mortality observed during the period under study. (JEL H51, I12, I18, N31, N32)

Was the First Public Health Campaign Successful? The Tuberculosis Movement and its Effect on Mortality

The U.S. tuberculosis movement pioneered many of the strategies of modern public health campaigns. Dedicated to eradicating a specific disease, it was spearheaded by voluntary associations and supported by the sale of Christmas seals. Although remarkable in its scope and intensity, the effectiveness of the tuberculosis (TB) movement has not been studied in a systematic fashion. Using newly digitized mortality data at the municipal level for the period 1900-1917, we explore the effectiveness of the measures championed by the TB movement. Our results suggest that the adoption of a municipal reporting requirement was associated with a 6 percent decrease in pulmonary TB mortality, while the opening of a state-run sanatorium was associated with an almost 4 percent decrease in pulmonary TB mortality. However, these and other anti-TB measures can explain, at most, only a small portion of the overall decline in pulmonary TB mortality observed during the period under study.

Influenza Pandemics and Tuberculosis Mortality in 1889 and 1918: Analysis of Historical Data from Switzerland.

BackgroundTuberculosis (TB) mortality declined in the northern hemisphere over the last 200 years, but peaked during the Russian (1889) and the Spanish (1918) influenza pandemics. We studied the impact of these two pandemics on TB mortality.MethodsWe retrieved historic data from mortality registers for the city of Bern and countrywide for Switzerland. We used Poisson regression models to quantify the excess pulmonary TB (PTB) mortality attributable to influenza.ResultsYearly PTB mortality rates increased during both influenza pandemics. Monthly influenza and PTB mortality rates peaked during winter and early spring. In Bern, for an increase of 100 influenza deaths (per 100,000 population) monthly PTB mortality rates increased by a factor of 1.5 (95%Cl 1.4–1.6, p<0.001) during the Russian, and 3.6 (95%Cl 0.7–18.0, p = 0.13) during the Spanish pandemic. Nationally, the factor was 2.0 (95%Cl 1.8–2.2, p<0.001) and 1.5 (95%Cl 1.1–1.9, p = 0.004), respectively. We did not observe any excess cancer or extrapulmonary TB mortality (as a negative control) during the influenza pandemics.ConclusionsWe demonstrate excess PTB mortality during historic influenza pandemics in Switzerland, which supports a role for influenza vaccination in PTB patients in high TB incidence countries.

Excess Mortality Associated with Influenza among Tuberculosis Deaths in South Africa, 1999-2009.

BackgroundPublished data on the interaction between influenza and pulmonary tuberculosis (PTB) are limited. We aimed to estimate the influenza-associated mortality among individuals with PTB in South Africa from 1999–2009.MethodsWe modelled the excess influenza-associated mortality by applying Poisson regression models to monthly PTB and non-tuberculosis respiratory deaths, using laboratory-confirmed influenza as a covariate.ResultsPTB deaths increased each winter, coinciding with influenza virus circulation. Among individuals of any age, mean annual influenza-associated PTB mortality rate was 164/100,000 person-years (n = 439). The rate of non-tuberculosis respiratory deaths was 27/100,000 (n = 1125) for HIV-infected and 5/100,000 (n = 2367) for HIV-uninfected individuals of all ages. Among individuals aged <65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-infected (relative risk (RR): 5.2; 95% CI: 4.6–5.9) and HIV-uninfected individuals (RR: 61.0; CI: 41.4–91.0). Among individuals aged ≥65 years, influenza-associated PTB mortality risk was elevated compared to influenza-associated non-tuberculosis respiratory deaths in HIV-uninfected individuals (RR: 13.0; 95% CI: 12.0–14.0).ConclusionWe observed an increased risk of influenza-associated mortality in persons with PTB compared to non-tuberculosis respiratory deaths. If confirmed in other settings, our findings may support recommendations for active inclusion of patients with TB for influenza vaccination and empiric influenza anti-viral treatment of patients with TB during influenza epidemics.

HIV/AIDS-related mortality in Africa and Asia: evidence from INDEPTH health and demographic surveillance system sites

BackgroundAs the HIV/AIDS pandemic has evolved over recent decades, Africa has been the most affected region, even though a large proportion of HIV/AIDS deaths have not been documented at the individual level. Systematic application of verbal autopsy (VA) methods in defined populations provides an opportunity to assess the mortality burden of the pandemic from individual data. ObjectiveTo present standardised comparisons of HIV/AIDS-related mortality at sites across Africa and Asia, including closely related causes of death such as pulmonary tuberculosis (PTB) and pneumonia.DesignDeaths related to HIV/AIDS were extracted from individual demographic and VA data from 22 INDEPTH sites across Africa and Asia. VA data were standardised to WHO 2012 standard causes of death assigned using the InterVA-4 model. Between-site comparisons of mortality rates were standardised using the INDEPTH 2013 standard population.ResultsThe dataset covered a total of 10,773 deaths attributed to HIV/AIDS, observed over 12,204,043 person-years. HIV/AIDS-related mortality fractions and mortality rates varied widely across Africa and Asia, with highest burdens in eastern and southern Africa, and lowest burdens in Asia. There was evidence of rapidly declining rates at the sites with the heaviest burdens. HIV/AIDS mortality was also strongly related to PTB mortality. On a country basis, there were strong similarities between HIV/AIDS mortality rates at INDEPTH sites and those derived from modelled estimates.ConclusionsMeasuring HIV/AIDS-related mortality continues to be a challenging issue, all the more so as anti-retroviral treatment programmes alleviate mortality risks. The congruence between these results and other estimates adds plausibility to both approaches. These data, covering some of the highest mortality observed during the pandemic, will be an important baseline for understanding the future decline of HIV/AIDS.

Evolutionary Trends for Pulmonary Tuberculosis Treatment Using DOTS in Sierra Leone: 1992-2010 Database Study

Background: Sierra Leone started the Direct Observation Treatment Strategy (DOTS) for the treatment of pulmonary tuberculosis in 1992. The country’s pulmonary tuberculosis (PTB) treatment program is now standardized according to international scale. Under the national standardized PTB treatment system, the regimen for new PTB patients consists of a 2-month intensive treatment phase with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by a 4-month continuation phase with rifampicin and isoniazid. Aims: To determine and analyse the annual PTB treatment success and incidence rates, treatment defaulters’ rate, and pulmonary tuberculosis mortality from 1992 to 2002 under the DOTS program at the Germany Leprosy Relief Association’s (GLRA) 13 regional diagnostic centers and chest clinics in Sierra Leone and to compare this data with the annual national tuberculosis data stored in WHO tuberculosis database covering the period 1992-2010. Study Design: The study retrospectively analysed pulmonary tuberculosis annual incidence rates for study subjects who registered for diagnosis and later for treatment at the GLRA 13 regional diagnostic centers and chest clinics from 1992 to 2002. From Research Article British Journal of Medicine & Medical Research, 3(4): 2076-2084, 2013 2077 these data we were able to determine the treatment success and defaulters’ rates, and PTB mortality for these subjects. We also analysed data of the annual national tuberculosis incidence and success rates, and mortality rates retrieved from World Health Organisation (WHO) TB data for Sierra Leone for the period 1992-2010. Twenty six (26) healthcare service providers were also interviewed for additional information about the main cause of mortality and reasons for treatment defaults among pulmonary tuberculosis patients during the period under investigation. Study Subjects: A total of 2,958 (1,881 men and 1,077 females) mostly adults of age range 15-65 years were diagnosed and later treated for pulmonary tuberculosis from 1992 to 2002 at the various GLRA diagnostic and treatment centers in the country. Setting: The study was a multicenter study conducted at the Germany Leprosy Relief Association’s (GLRA) main referral diagnostic center and chest clinic at Lakka in Freetown and the Department of Environmental Health Sciences, Njala University in Bo, Sierra Leone. Pulmonary tuberculosis treatment outcomes data used in this study were obtained from TB patients who were admitted at various GLRA chest clinics in Sierra Leone from 1991-2002. Data analysis and literature reviews were done at the Department of Environmental Health Sciences, Njala University in Bo, Sierra Leone from 2011 to 2012. Results: The most important finding of this investigation was that the annual pulmonary tuberculosis incidence and treatment success rates (% cured rate and % completed treatment rate) rose significantly during the period under review for both the GLRA’s study subjects and the cases stored in the WHO tuberculosis database. Conclusion: The significantly high and growing number of annual PTB incidence rates during this HIV/AIDS epidemic reinforces the need for routine PTB treatment monitoring and supervision as well as compulsory HIV testing for tuberculosis patients seeking treatment.

Risk Factors Related with Mortality in Patient with Pulmonary Tuberculosis

BackgroundThe prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB.MethodsFrom December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females).ResultsMortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis.ConclusionIn our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.

Demographic, health services and socio-economic factors associated with pulmonary tuberculosis mortality in Los Altos Region of Chiapas, Mexico

Chiapas is one of the Mexican states having the highest rates of Pulmonary Tuberculosis (PTB), due to the numerous factors impeding its management and control (poverty, poor housing and nutrition, shortage of health resources, among others). To analyse the PTB mortality of a cohort of patients in Los Altos Region of Chiapas, who had been diagnosed with PTB from January 1, 1998 to December 31, 2002; and, to identify demographic, socioeconomic and health services utilization factors, associated with death from PTB. Analysis of a cohort of patients aged over 14 years diagnosed with PTB in the above mentioned period (n = 431) in Los Altos region of Chiapas. The records of the Tuberculosis Programme were reviewed, and patients were located through a search attempting to locate them in their homes. Those found alive were interviewed and asked to provide sputum samples. In the case of deceased patients, a verbal autopsy was obtained from a member of their family. The records of the PTB Programme in the area were incomplete and erroneous in many cases. The results of the home follow-up visits were: 208 (48%) patients located alive, five of whom were still PTB positive (three with multi-drug resistance); 145 (34%) could not be located and 78 (18%) had already died. Apparently, in at least 40 cases, the deaths were associated with PTB. Of these forty, 33 (83%) died without having received any medical care. The factors associated with dying from PTB were: 45 and over years of age (OR = 1.3; 95% CI = 0.98-1.3), 0-3 schooling years (OR = 3.3; 95% CI = 1.1-9.6), engaged in agriculture (OR = 2.2; 95% CI = 1.1-4.4), not living in main villages of their municipality (OR = 1.2; 95% CI = 1.0-1.3), living in a rural community (OR = 2.7; 95% CI = 1.1-6.8), not having been treated in DOTS (OR = 1.2; 95% CI = 1.0-1.3) and having defaulted from treatment (OR = 11.5; 95% CI = 5.3-24.8). The high rate of mortality due to PTB observed constitutes a serious public health problem deserving attention. There is an urgent need to evaluate and restructure the Tuberculosis Programme in the studied area.

Trends in mortality from pulmonary tuberculosis and HIV/AIDS co-infection in rural South Africa (Agincourt)

This study investigates trends and age-and-sex patterns of mortality in pulmonary tuberculosis (PTB) and PTB/HIV co-infection in a rural population of South Africa. The PTB/HIV mortality emerged in 1994, and has been rising ever since (men: P=0.001; women: P=0.020, test for trend). In the last 2 years, for both sexes combined, 63% (95% CI 51-74%) of PTB deaths were attributable to HIV/AIDS. PTB/HIV death rate was higher in men than in women for all ages combined (RR(MH)=2.48, 95% CI 1.53-4.04, P<0.001). PTB/HIV death rate was also higher in younger individuals (<25 years) compared with PTB without HIV/AIDS (P=0.033), and the median age at death from PTB/HIV in women (28 years) was lower than in men (38 years, P=0.002). While mortality from PTB without HIV remained constant over time, HIV/AIDS explained the rise in PTB mortality. In the last 3 years, the HIV/AIDS epidemic has caused the number of persons dying of PTB to increase by +117%, with the mortality excess being higher in women (+164%) than in men (+103%, P=0.001). Combined PTB and HIV programme activities need to be reinforced to respond to the increase in PTB mortality, particularly in women.

Historical intensity of natural selection for resistance to tuberculosis.

Infections have long been thought to exert natural selection on humans. Infectious disease resistance is frequently invoked as a mechanism shaping human genetic diversity, but such hypotheses have rarely been quantitatively evaluated with direct measures of disease-related mortality. Enhancement of genetically determined resistance to tuberculosis by natural selection has been proposed as a factor explaining the decline of tuberculosis in Europe and North America in the period 1830-1950 (before the advent of antimicrobial chemotherapy) and the apparently reduced susceptibility of Europeans and their descendants to tuberculosis infection and/or disease. We used Swedish vital statistics from 1891 to 1900 to estimate that individuals who escaped mortality from pulmonary tuberculosis (PTB) during the European tuberculosis epidemic would have enjoyed a fitness advantage of 7-15% per generation compared to individuals who were susceptible to PTB mortality; individuals with 50% protection would have had a selection coefficient of 4-7%/generation. Selection during the peak of the European TB epidemic could have substantially reduced the frequency of already rare alleles conferring increased susceptibility to PTB mortality, but only if the phenotypic effects of these alleles were very large. However, if resistant alleles were rare at the beginning of this period, 300 years would not have been long enough for such selection to increase their frequency to epidemiologically significant levels. Reductions in the frequency of rare susceptibility alleles could have played at most a small part in the decline of the epidemic in the century preceding 1950. Natural selection by PTB deaths during the European TB epidemic alone cannot account for the presently low level of TB disease observed among Europeans and their descendants just prior to the appearance of antibiotic treatment.

Rising case fatality of bacteriologically proven pulmonary tuberculosis in The Netherlands

Analysis of registration cards from the Tuberculosis Control Program (TCP) showed a four-fold increase in case fatality of bacteriologically proven pulmonary tuberculosis in Dutch patients in the period 1973–1984. Registered data of 125 deceased patients whose primary cause of death was pulmonary tuberculosis were analyzed. Increased case fatality predominantly occurred in the elderly. Elderly patients presented often with other, less specific, complaints than coughing, but had a shorter combined patient's and doctor's delay than younger patients. The elderly were more often treated with 3 tuberculostatic drugs (INH, pyrazinamide, rifampin). Bacterial resistance was found in only 2%. Probably the most important factor concerning the raised case fatality in the elderly is the decline in immune response, due to ageing of the Dutch population. An effective response to tuberculostatic drugs needs a reasonably intact immune response. Declining immunity of the elderly group will increase incidence and mortality of pulmonary tuberculosis in this group.

TUBERCULOSIS OF THE GASTROINTESTINAL TRACT.

Chemotherapy has dramatically reduced the morbidity and mortality of pulmonary tuberculosis. An even more striking reduction has occurred in the incidence of secondary tuberculous infections of the gastrointestinal tract. Patients with intestinal tuberculosis may present, however, without any evidence of pulmonary tuberculosis. Although tuberculous enteritis is uncommon, it requires consideration in the differential diagnosis of many gastrointestinal lesions as it may simulate nontuberculous inflammatory processes or neoplasms. Such consideration may result in a correct diagnosis and the institution of proper therapy. During the 15-year period, 1946-1960, 15 patients with gastrointestinal tuberculosis were treated at the University Hospitals and the United States Veterans Hospital in Cleveland (Table). The patient population of both hospitals excludes individuals with known pulmonary tuberculosis. This small series obviates a statistical study; rather, case summaries from this group will be used to clarify or illustrate points of diagnosis and therapy. Case Summaries Incidence. —The concomitant occurrence of

Pulmonary tuberculosis mortality in the printing and shoemaking trades historical survey, 1881-1931.

Pulmonary tuberculosis mortality in the printing and shoemaking trades historical survey, 1881-1931.

THE PRESENT STATUS OF THE TREATMENT OF PULMONARY TUBERCULOSIS

Article1 August 1936THE PRESENT STATUS OF THE TREATMENT OF PULMONARY TUBERCULOSISLAWRASON BROWN, M.D., F.A.C.P.LAWRASON BROWN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-10-2-147 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe marked decrease in the mortality of pulmonary tuberculosis is undoubtedly due to many causes. It is not, many hold, a true measure of the decrease of the morbidity of the disease. Pulmonary tuberculosis is still a very menacing cause of death to both sexes during the period of greatest bodily and mental activity. The keen desire for a cure for tuberculosis, a true therapia magna sterilisans, so widely spread at the beginning of the century, is now less evident. Some foundations and laboratories consider tuberculosis an unpromising field of endeavor and have left it largely to the clinicians and... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Saranac Lake, N. Y.*Presented at the Detroit meeting of the American College of Physicians, March 6, 1936. Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTHE AMBULATORY TREATMENT OF PATIENTS HOSPITALIZED WITH PULMONARY TUBERCULOSIS*JAMES A. WIER, ROBERT L. TAYLOR, RICHARD S. FRASER 1 August 1936Volume 10, Issue 2Page: 147-155KeywordsMorbidityMortality ePublished: 1 December 2008 Issue Published: 1 August 1936 PDF downloadLoading ...