027 |
RELAPSE AMONG NATURALLY CURED CASES OF PULMONARY
TUBERCULOSIS |
AK Chakraborty & GD Gothi: Indian J TB 1976,
23, 8-13. |
The five year longitudinal epidemiological study
in south India (1961-68) showed that a considerable proportion of
bacteriologically proven cases found in a survey got cured naturally
without the facility of organised treatment in the survey area.
This "natural cure" could be an epidemiologically significant
phenomenon- depending on the stability of such a cure or in other
words, the frequency of relapses among the naturally cured. In all,
108 naturally cured cases of tuberculosis out of a total of 269
cases, from among about 62,000 persons surveyed twice, were followed
up for varying periods of 1 to 3½ years.
It was observed that the average relapse rate was
85.4 per 1000 person years of observation, there being no difference
between the two sexes. Relapse rates were however higher in persons
aged 20 and more compared to those 5-10 years old. Relapses were
not dependent on the bacteriological status at initial diagnosis
i.e., whether positive by culture alone or positive by smear and
culture. The death rate among the naturally cured was 42.7 per 1000
person years and together with relapse constituted the unfavourable
fate after natural cure. It has been calculated that as an input,
adding to the pool of bacillary cases in the community, the ratio
of relapse cases to cases arising afresh from the general population
in a year would roughly be in the order of 1:16. It is concluded
that the naturally cured status could be considered as an epidemiologically
favourable situation, though much less so when compared to the chemotherapeutically
achieved cure.
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KEY WORDS: RELAPSE, NATURAL CURE, CASE, RURAL
POPULATION, SURVEY. |