長期に亘る農村結核集団検診より見た結核症の家族的観察に就て
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概要
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As part of long-term statistical studies on pulmonary tuberculosis among the inhabitants of Goi, a farming community with a population of about 12,000, where periodic mass examinations had been performed every year during the period from 1947 through 1956, studies were carried out on tuberculous infection within families, especially on the influence of the presence of tuberculous parents on their children. All the families investigated were grouped into the following three categories according to the results of roentgenographic examinations of parents (in accordance with Oka's classification of the types of pulmonary tuberculosis) : (1) families of parents with active tuberculosis Cgroup 1), (2) families of parents with cured tuberculosis (group 2), and (3) families of parents with no pulmonary involvement (group 3). Transition in the reaction to tuberculin tests, the result of BCG inoculation and the development of pulmonary ininvolvement within each group of families were investigated and compared. 1. The ratio of the number of tuberculin reactors at the time of initial examination to the total number of persons examined was higher in group 1 than in any other group. The rates within younger age groups were markedly higher in group 1. The ratio of the number of persons converting from tuberculin positive to tuberculin negative status after producing positive reactions on initial examination to the total number of persons producing positive reactions on initial examination was more or less the same for all the groups. 2. Persons who hecame tuberculin-positive because of fresh infection following BCG inoculation were found in greatest number in group 1, while persons who did not easily acquire sensitivity to tuberculin following repeated BCG inoculations tended to be slightly larger in number in group 3. 3. The ratio of the number of persons with pulmonary involvement to the total number of persons investigated was higher in group 1 than in any other group. Considerably large percentage of persons with pulmonary involvement within group 1 had pulmonary tuberculosis of type ff or VIII (active tubersulosis), but the majority of persons with pulmonary involvement within the other two groups had pulmonary tuberculosis of type VIII B, IX or X (cured tuberculosis). Among the members of group 1, there were two patients who, having had positive tuberculin tests with no pulomnary involvement on initial examination, subsequently developed pulmonary involvement. In either of the groups, there was not a single person who developed pulmonary involvement among those who had not easily acquired sensitivity to tuberculin in spite of repeated BCG inoculations. 4. The data indicate that the presence of sputum-positive adults within families is the main cause of infection with tuberculosis and subsequent development of pulmonary involvement among the people in the agricultural community, especially among children who are most susceptible to tuberculosis. The fact that there were a considerably large number of persons developing pulmonary involvement within group 1 despite repeated BCG inoculations has convinced the author that segregation of patients with active tuberculosis, as well as stricter enforcement of BCG inoculation, is urgently needed for prevention of tuberculosis.
- 千葉大学の論文
- 1959-03-28
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