ネパールの結核対策 : 平地部と丘稜部での結核対策キャンペインの能率差
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概要
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The results of a one-year anti-tuberculosis campaign in Nepal between October 1976 and September 1977 were analyzed in relation to the difference in the efficiency of efforts between the plains area and the hilly area.<BR>Three representative districts in each of the plains and hilly areas were selected. The door to-door visit method was used in these areas, and the BCG vaccinators here were able to visit every house to give BCG vaccination and detect evident cases of pulmonary tuberculosis. They also inquired about the family composition (registered population) and collected sputum specimens from people with suspicious chest symptom among family members 15 years of age and over residing at home (contacted population).<BR>The results were summarized as follows;<BR>1) The ratio of the number of persons with whom the BCG vaccinators actually contacted for interview when they visited their house (the contacted population) to the total population was as follows;<BR>in all-age groups, 39% in the plains area, and 50% in the hilly area, and the average was 45%. Hilly area>Plains area (<I>p</I><0.001). in adults of 15 years of age and over, 34% in the plains area, and 41% in the hilly area, and the average was 38%. Hilly area>Plains area (<I>p</I><0.001). in children under 15 years of age, 47% in the plains area, and 64% in the hilly area, and the average was 55%. Hilly area>Plains area (<I>p</I><0.001).<BR>2) The ratio of the contacted population to the number of persons who were confirmed by the BCG vaccinators and registered through the interview (registered population) was as follows;<BR>in all-age groups, 64% in the plains area, and 56% in the hilly area, and the average was 59%. Plains area>Hilly area (<I>p</I><0.001).<BR>in adults 15 years of age and over, 55% in the plains area, and 47% in the hilly area, and the average was 50%. Plains area>Hilly area (<I>p</I><0.001).<BR>in children under 15 years of age, 78% in the plains area, and 69% in the hilly area, and the average was 73%. Plains area>Hilly area (<I>p</I><0.001).<BR>3) Paragraphs (1) and (2) above clearly show that the ratio of contacted population to registered population is higher in the plains area than in the hilly area, though the ratio of the number of persons with whom the BCG vaccinators were actually able to contact to the total population (contacted population/total population), in other words, the efficiency of the initial stage of the door-to-door visit method of anti-tuberculosis campaign in which patients are detected and cured, is higher in the hilly area than in the plains area.<BR>This results from the fact that the number of unregistered families and family members was greater in the plains area than in the hilly area.<BR>4) The ratio of the number of symptomatic cases to the size of the contacted population of 15 years of age and over was 3. 8% in the plains area, and 5. 5% in the hilly area, and the average was 4. 7%. Hilly area>Plains area (<I>p</I><0.001).<BR>5) The sputum smear positive rate among the contacted population of 15 years of age and over was 0.15% in the plains area, and 0.22% in the hilly area, and the average was 0.19%. Hilly area>Plains area (<I>p</I><0.001).<BR>6) The sputum smear positive rate among the symptomatic cases was 3.98% in the plains area, and 3.99% in the hilly area, and the average was 3.98%.<BR>Since the sputum smear positive rate among the symptomatic cases was similar in the plains and hilly areas (<I>p</I>>0.9) in spite of the fact that the ratio of symptomatics and sputum smear positives to the contacted population of 15 years of age and over was higher in the hilly area than in the plains area as shown in paragraphs (4) and (5) above, it appears that the sensitivity of symptomatic case-finding method is constant.
- 日本結核病学会の論文
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関連論文
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