[Medical risk factors of tuberculosis and countermeasures]

We describe the actual situation of and measures for medical risk factors of tuberculosis in compromised hosts and elderly people. Cases of diabetes mellitus, collagen disease and lung cancer administered corticosteroid preparations are taken up as compromised hosts. The frequency of TB patients having diabetes mellitus concurrently tends to increase, and the relative risk of diabetics developing tuberculosis is also high. Physicians giving diagnosis and treatment of diabetes mellitus should understand that diabetics belong to the high risk group of developing tuberculosis and perform chest X-ray examination periodically. In order to prevent the development of tuberculosis from diabetics, it is considered preferable to give chemoprophylaxis where there is no history of TB treatment and healing of TB has been found on the chest X-ray films. Where corticosteroid preparation, more than 10 mg in terms of prednisolone is administered over a long period of time for collagen diseases except rheumatoid arthritis and lung cancer, chemoprophylaxis is considered desirable. As for the present situation of the elderly TB patients among in-patients at our hospital, the elderly often had serious complications, their prognosis was poor and they often died of the diseases other than tuberculosis. To strengthen the measures to deal with tuberculosis in the elderly, early discovery and prophylaxis of pulmonary tuberculosis are considered. For the early discovery when the patient is symptomatic, the examination of sputum along with chest X-ray examination is important. As for the periodical health examination, the patients with the risk of infection to those around them being high need to undergo the health examination for sure. As the prophylactic measures, chemoprophylaxis is recommended where there is no history of TB treatment and healing of tuberculosis has been found on chest X-ray films.