| Epidemiological Study of Pulmonary Tuberculosis Patients Registered at Urban Health Centers -Based on Cumulative Defaulting Rates by Life Table Method- |
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Hyung Jong Park, Kil Won Kang, Ki Moon Bang, Jae Woong Hong, Soon Yong Park |
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School of Public Health, Seoul National University, Seoul, Korea |
| 결핵치료환자에 대한 사회의학적 조사 연구 -보건소 등록환자에 대한 루적중단율을 중심으로- |
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박형종, 강길원, 방기문, 홍재웅, 박순영 |
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| Abstract |
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A socio-medical survey was conducted towards 245 TB patients registered at 9 health centers in Seoul from.
November to December 1968. From February to June 1970, 9 tuberculosis follow up workers visited 245 patientsfor enquiring the treatment status as of the end of 1969, and the following conclusions were obtained. ( The cumulative termination rates by life table method were based on 864 TB cases registered 5 health centers
during same period.)
1) General Characteristics of the Patients Registered at Health Centers:
By sex, male patients rated 64.9 percent and female were 35. 1 percent.
By age, 20-49 group rated 71. 6 percent of the total or highest, 19 years or below were 13.8 percent and those more than 50 were 14. 6 percent.
A substantially large proportion or 65 percent of male patients had received a middle school education or more, of the female those having primary school background or below rated 62.4 percent.
By occupation ( engaged longest) in the past, twenty-eight percent of male patients turned out to have no occupation at all, and laborers, sales workers and clerical workers constituted 48.3 percent. The rate of no, occupation was increased by 32 percent at the time of discovery of tuberculosis and 51. 7 percent or almost.
double at the time of follow up visit.
For judging a living standard of the patients, about 37 percent of patients turned out to have their own
houses and 57.5 percent were living in houses rent by advanced payment or monthly rent.
Almost 77 percent of the patients were exposed to radio regularly and in 48 percent to newspaper.
As source of drinking water supply, private water constituted 56.5 percent of all sources.
2) Those of the date of admission for treatment registered from October to December 1968 rated 54. 6 percent, those registered during 1968 turned out to be 71. 9 percent, and 28 percent registered in 1967 or before.
By duration from discovery of tuberculosis to registration, those registered immediately after initial diagnosis were proven to be 35.5 percent, those registered within one month rated 48.2 percent and 51. 8 percent registered after one month.
By the history of treatment, 38.6 percent turned out to have no treatment at all, and 39.6 percent treated
continuously after initial diagnosis. Those started treatment recently were 9. 1 percent and those treated only in the past rated 12.7 percent.
In regard to initial diagnosis, 46.1 percent were diagnosed by sputum examination, and 80.4 percent by
X-ray. The positive rate of tuberculosis bacilli was proven in 18.8 percent, and according to extent of disease,
minimum cases were 48.2 percent or highest, moderately advanced cases rated 26.4 percent and far advanced
cases turned out to be 15.7 percent
3) Findings on Status Subsequent to Registration at Health Center:
In regard to the sources of information to know health center as place of tuberculosis treatment, “neighbors,
relatives or friends" were 33 percent or highest, medical personnel rated 15.2 percent, “mass media" rated
13. 1 percent and personnel in health center turned out to be 7.9 percent.
By the motivation of registration, the recommendation of personnel in health center turned out to be 30.9 percent, the recommendation of neighbors or relatives rated 14.1 percent, the economical difficulties in treatment rated 12.6 percent and the recominendation of medical personnel was 11. 1 percent.
As subjective symptoms, fatigue was the most frequent symptom or 69.9 percent, weight loss in 48.2 per
νcent, mild fever 35.2 percent, chronic cough and hemoptysis 23.3 percent respectively, chillness 22.7 percent and chest pain 21. 2 percent. About 7 symptoms above, 55.5 percent of the patients complained 1-2 symptoms,
25.9 percent complained 3-4 symptoms and those complained more than 5 were 11.9 percent.
Those who were living a separate room (patient alone) were 8 percent only, and 92 percent of the patients were living with family members in same room. Twenty-eight percent were living with 1-2 family members in same room, 38.4 percent with 3-4 members and 25.6 percent with more than 5 members.
According to the answer of the patients, 12.9 percent of the patient had another patients in their family.
Among family patients, 91 percent registered at health center already.
4) Cumulative Defaulting Rates by Reasons and Months of Treatment:
The continuation rate of treatment after registration was 61. 2 percent for 12 months and 38. 8 percent
discontinued treatments less than one year after treatments. As the defaulting reasons of treatments, the lost to foIIow up due to incorrect addresses or move out was 18.4 percent, the termination due to complete treatment rated 11. 8 percent, the personal reasons ( forgot or busy to take drugs, trip to country, seIf treatment, reject of treatment etc.) were 3.1 percent, the medical reasons (death, free of symptoms, side-effects etc. ) rated 1. 6 percent and the non-relevant reasons were 3.8 percent.
By the cumulative defaulting rates by life table method by reasons of defaulting and months of treatment,
the total cumulative defaulting rates by various reasons were 4.6 percent at the end of 3 months, 14.0 percent at 6 months, 25.9 percent at 9 months, 41. 0 percent at 12 months and 48.4 percent at 14 months. When defaulting rates were evaluated by type, the defaulting rate by lost to foIIow up constituted the largest part of the total.
The net cumulative defaulting rates by lost to foIIow up were 7.0 percent at 6 months and 18.9 percent at 12 months.
The net cumulative defaulting rates by medical, personal and non-relevant reasons were 3.7 percent and 9.3 percent respectively.
At the end of 12 months, the cumulative defaulting rates constituted 46 percent of the total defaulters, those by complete treatment 31 percent and those by medical, personal and non-relevant reasons constituted 23 percent of the total defaulting rates.
If the defaulting rates by complete treatment were excIuded from termination, the total cumulative termination rates were decreased towards 10. 7 percent at 6 months, 28. 2 percent at 12 months and 33. 7 percent at 14 months. |
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