National Tuberculosis Prevalence Survey Research Articles

Public–private mix DOTS in the Philippines

The National Tuberculosis Prevalence Survey done in 1997 (1997 NPS) revealed that the magnitude of tuberculosis in the Philippines hardly declined between 1982 and 1997. In 1996, the National TB Control Program (NTP) adopted the directly observed treatment short-course (DOTS) strategy. By the end of 2001, more than 90% of the population have access to it. Cohort analysis revealed good treatment outcomes. Despite this improvement in the public sector, there is a concern that the epidemiological impact of DOTS will be limited due to the non-participation of the private practitioners, a major stakeholder. Public–private sector collaboration in TB control was strengthened since the Philippine Coalition Against TB (PhilCAT) was organized in 1994. There are four areas of collaboration, namely, policy development, advocacy and information dissemination, training and research and service delivery. Four models of public–private mix (PPM) DOTS in service delivery were developed. The private DOTS clinics provide the space, staff and operational funds while the Department of Health (DOH) provided technical assistance, anti-TB drugs, laboratory supplies and forms. Evaluation showed that PPM in TB control is feasible with good results. The major challenge is to replicate and institutionalize the PPM DOTS.

The characteristics and fates of pulmonary tuberculosis patients seen at medical department of a medium sized general hospital.

Background: There were many reports about the clinical aspect and outcomes of pulmonary tuberculosis in health center but few in a medium sized general hospital. The purposes of this study were to find any characteristic differencies in the patients and the general outcomes of the treatments and also to give some suggestive points for the insurance policy making. Methods: We made a retrograde analysis of the medical records of 1981 patients (male 992 female 1,059) who attended our clinics of the 4th internal department, Daedong general hospital during two years from January 1989 to December 1990. Result: 1) Of 1981 patients, 96 were diagnosed as pulmonary tuberculosis taking relatively large proportion in the prevalence. The ratio of prevalence between male and female was 7.81% to 2.27%. The 61.46% were the first diagnosis & initial treatment cases and the remaining 38.54% were the retreatment cases with no statistical significance between sex. 2) The most prevalent age group was between 21~40 years old and the prevalence rate was 45.45% of male and 76.76% of female. The lowest age group in male patient was above 61 showed 3.03%, and there was no female patients above age 60 years old. This phenomena could be thought as the negligence for the treatment of pulmonary tuberculosis in the old age groups rather than true tuberculosis prevalence and it could be proved by the higher rates towards old age groups in the national tuberculosis prevalence survey. 3) There were 57.07% of the minimal case, 48.96% of the moderate, 18.75% of the far advanced. The sputum examination showed 37.07% were culture positive, 46.88% were the negative, and 15.63% of the patients had no stutum examination. Moreover, uncoperatives among the far advanced cases were notable showing 22.22% of the stutum examination, where 16.13% in the minimal cases. The stutum positive rate among the initial treatment cases were 41.07% and 55.00% for the retreatment cases. The sputum no examination rates were 17.86% and 12.50% respectively. 4) The classfication of the mode of disease onset showed 68.75% with gradual onset, 9.38% hemoptic, 3.13% acute pneumonic and 18.75% was found through the radiologic examination in various occasions. 5) The percentages of patients who continued their treatment for more than 8 month were 35.71% (for initial treatment), 25.00% (for retrement), 16.13% (for the minimal), 27.78% (for the far advanced). 6) The group of patients who were treated more than 8 months showed the negative conversion rate of 80% on sputum and marked improvement on chest x-ray in 56.67%. However, in far advanced or retreatment cases, the rate of negative conversion on sputum and the rate of improvement on chest x-ray were low being 60% and 20% for the former and 60% and 10% for the latter, each respectively. Conclusion: It would be strongly emphasized that the improvement of National medical insurance system and social welfare system in Korea must be definite to improve overall treatment and control of tuberculosis diseases as well as physician's devotious National tuberculosis control policy.

Elimination of tuberculosis in Japan

According to the operational definition adopted at Wolfheze Workshop held in March 1991 (Table 1), tuberculosis low incidence countries are defined as those where the incidence of all forms of tuberculosis is less than 1 per 100,000. The incidence was 41.9 in 1990 in Japan, so that Japan cannot be considered as a low incidence country. Why is the incidence of tuberculosis so high in Japan? What part of population is affected by the tuberculosis disease? To solve these questions and to make clear the mode of development of tuberculosis, a study was carried out. Fortunately, both the annual risk of tuberculosis infection and the prevalences of persons with healed and/or fibrotic lesion in the lung are known from the results of the National Tuberculosis Prevalence Surveys carried out in 1963 and 1973 as shown in Figures 1 and 2. From these data, the number of newly infected within 5 years and that of remote infections by age group were estimated. The former was divided into BCG vaccinated and non-vaccinated and the latter into persons with fibrotic lesion, with healed foci and without abnormality in the lung. (Table 2). The rates of development of tuberculosis disease according to the X-ray findings of the lung were observed at the five-years follow-up study of all the examinees at the Prevalence Survey carried out in 1968. The ratio of development of the disease in those with recent infections, remote infections with fibrotic lesion, those with healed foci and those without abnormality was estimated as 20 : 10 : 2 : 1. (Table 3)(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Resistance of Mycobacterium tuberculosis isolated from Patients discovered in the Third National Tuberculosis Prevalence Survey in 1975 in Korea

Drug Resistance of Mycobacterium tuberculosis isolated from Patients discovered in the Third National Tuberculosis Prevalence Survey in 1975 in Korea

Drug Resistance of M. tuberculosis Isolated from Patients Discovered In The Second National Tuberculosis Prevalence Survey

Drug Resistance of M. tuberculosis Isolated from Patients Discovered In The Second National Tuberculosis Prevalence Survey

Preliminary Report of the 2nd National Tuberculosis Prevalence Survey and Discussion of Tuberculosis Control Programme in Future

Preliminary Report of the 2nd National Tuberculosis Prevalence Survey and Discussion of Tuberculosis Control Programme in Future