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[Tuberculosis in young generation: a report from six general hospitals]
Y Murata1, K Kusajima, F Ooisi
1Department of Internal Medicine, Tachikawa Sohgo Hospital, Tokyo, Japan.
Insights
Tuberculosis risk is highest in young adults, with outbreaks linked to epidemics and familial spread. Ambulatory treatment showed no relapse, with familial cases attributed to delayed diagnosis, not treatment methods.
Area of Science:
- Epidemiology
- Clinical Medicine
- Public Health
Background:
- Tuberculosis (TB) remains a significant global health concern.
- Understanding age-specific risks and treatment challenges is crucial for effective control.
- Previous studies have not fully elucidated the epidemiological and clinical features of TB in younger populations.
Purpose of the Study:
- To investigate the epidemiologic and clinical aspects of tuberculosis in the young generation.
- To identify challenges in the ambulatory treatment of tuberculosis.
- To compare TB characteristics across different age groups.
Main Methods:
- Retrospective analysis of 418 tuberculosis cases diagnosed between 1983 and 1991 in six Tokyo hospitals.
- Classification of patients into three age groups: young (10-29 yrs), middle-aged (30-69 yrs), and elderly (≥70 yrs).
- Investigation of risk factors, case-finding methods, radiological findings, extra-pulmonary lesions, diagnostic methods, epidemic links, patient/doctor delays, drug regimens, and patient compliance.
Main Results:
- The estimated risk of clinical breakdown was exceptionally high in the young TB group.
- Sixteen percent of young patients were linked to epidemics, and 8% to familial outbreaks.
- Atypical radiographic findings and extra-thoracic lymphadenopathy were more common in young and elderly groups.
- No relapses were observed in ambulatory-treated patients; familial outbreaks were linked to delayed diagnosis.
Conclusions:
- Young individuals face a significantly higher risk of tuberculosis clinical breakdown.
- Ambulatory treatment appears effective, with no observed relapses.
- Delayed diagnosis, rather than ambulatory treatment itself, is a key factor in the spread of tuberculosis within families.
Abstract:
We investigated epidemiologic and clinical aspects of tuberculosis in young generation and pointed out problems in ambulatory treatment. In six general hospitals in Tokyo, 418 cases of tuberculosis (285 males and 133 females) were diagnosed between 1983 and 1991. They were divided into three groups; 1) young group, 10 to 29 yr (62 cases), 2) middle age group, 30 to 69 yr (255 cases), 3) elderly group, above 70 yr (101 cases). And the risk of clinical breakdown, method of case finding, radiological findings, extra-pulmonary lesions, method of diagnosis, relationship with epidemics, patient's delay, doctor's delay, drug regimens and patient's compliance in each group were investigated. In addition, after completion of therapy we sent them survey questions about relapse and attack of tuberculosis among their families. Results were followings. 1) Estimated risk of clinical breakdown by age was calculated as follows, (the number of patients)/(the population of Tokyo)/(estimated incidence of infection). This was extremely high in young group. 2) Sixteen percent of patients in young group were related with epidemics and another eight percent with familial outbreaks. 3) Although many patients in young group showed focal lesions in chest radiographies, the rate of symptomatic patients was 61% and that was almost same as in other groups. 4) The rate of patients showing atypical radiographic findings, extra-thoracic lymphadenopathy and idiopathic pleuritis were relatively high in young and elderly group. 5) Results of survey questions showed no relapse among ambulatory treated patients. Familial outbreaks (three cases) were thought to be caused by long patient's delay and not by ambulatory treatment of smear-positive patients.(ABSTRACT TRUNCATED AT 250 WORDS)