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Korean Journal of Epidemiology 2003;25(2): 92-99.
The Characteristics of Relapsed Patients with Pulmonary Tuberculosis Registered at Two Public Health Centers in Seoul.
Songyi Han, Soonduck Kim, Jongsoon Park, Seonmi Ji, Jesuk Lee
1Graduate School of Public Health Korea University, Korea.
2Department of Preventive Medicine, College of Medicine,Korea University, Korea. kimsd@korea.ac.kr
Abstract
PURPOSE:
The purpose of this study is to survey general and clinical characteristics of a group of relapsed patients with pulmonary tuberculosis, who are registered at a public health center in order to provide basic data for treatment of a patient's relapse, follow-up examination after the first treatment and health education. SUBJECT: Among 68 relapsed patients with pulmonary tuberculosis registered at two public health centers in Seoul from Jan, 1, 2002 to Dec. 31, 2002, 50 patients were selected as research subjects because they were contactable by telephone and they agreed to be a research subject.
METHOD:
The research carried out the structured questionnaire survey by telephone and surveyed research subjects' general and clinical characteristics, diseases except tuberculosis, drinking and smoking habit and knowledge about pulmonary tuberculosis treatment. Furthermore, the results of x-ray, whether a cavity existed or not, bacteriologic test, culture examination and drug resistance examination were examined and interval to relapse and history of dose attitude were surveyed.
RESULTS:
Among relapsed tuberculosis patients, male patients were 60% and they were more than women(40%). Patients over 60 were 42% most. In their occupation, 30% of them were unemployed and 50% of patients surveyed had monthly income below one million won. According to the findings in radiographic extent, most 50% of them were minimal, 44% were moderately advanced and 2% were far advanced. Patients who had cavity were 30%. According to the result in bacteriologic test, 54% showed positive smear pulmonary tuberculosis and 50.0% positive culture. According to the result in drug resistance, 24% showed drug resistance against one drug and 76% showed sensitive response. 46% had experienced medication side effects. According to interval to a relapse, 32% were relapsed less than 2 years, 14% less than 3-5 years and 54% more than 5 years. Average interval before a relapse were 11.6 years(11.6+/-11.15). There was a difference between their past regimen and their present regimen(P=0.001). The attitude towards taking a medication was assessed and they showed higher compliance with medication at present than in the past(P=0.001). In a case of smoking rate during treatment, the rate of non-smokers, who had been smokers, were higher(P=0.047).
CONCLUSION:
As a result, in order to prevent the disease from being relapsed and to increase the rate of treatment effectiveness, we need to make patients recognize the importance of regular follow-up examination and we should control thoroughly the patients. Furthermore, we need to provide them with more health education not to stop taking a medication earlier.
Keywords: pulmonary tuberculosis; relapse; public health center


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