開発途上国における結核問題
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概要
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Approximately 3 billion people are living in developing countries and 4 to 5 million new smear positive tuberculosis cases are coming out every year. More than 3 million patients are dying from tuberculosis, yearly. The annual risk of tuberculosis infection, a new reliable index to measure the magnitude of tuberculosis problem, is on the level of 0.1 to 0.3% in technically developed countries, and it has been decreasing at the annual rate of 10 to 15%, while the rate is 2 to 5% in the majority of developing countries, and there has been no or only a slight decline. Thus, tuberculosis is still a serious problem in the developing world.<BR>The objective of the national tuberculosis control programme is to reduce tuberculosis problem in the community as fast as possible with minimum budget. WHO set the following guideline of tuberculosis programme:<BR>1) Tuberculosis programme should be nationwide and cover rural areas, where the majority of the population are living.<BR>2) The programme should be permanent and be continued for several decades.<BR>3) The programme should be integrated into primary health care system.<BR>4) Technical supervision for primary health care workers is essential.<BR>5) Methods used in the programme should be simple, easily feasible, effective, less costly and acceptable.<BR>6) Priority of the programme should be given to smear positive pulmonary tuberculosis.<BR>WHO recommends BCG vaccination, case-finding by sputum microscopy for symptomatics and domiciliary treatment for detected smear positve cases with standardized regimen of chemotherapy.
- 日本結核病学会の論文