Problems in running a tuberculosis dispensary in a developing country: Turkey

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Rising tuberculosis trends in Turkey post-1970 were suspected to be linked to declining dispensary use.
• Previous data supporting this link were insufficient.
• This study evaluates tuberculosis dispensary services in Elaziğ, Turkey.

Purpose of the Study:

• To evaluate the utilization and effectiveness of tuberculosis dispensary services in Elaziğ between 1985-1989.
• To identify factors contributing to the rising trend of tuberculosis.
• To propose improvements for tuberculosis control programs.

Main Methods:

• Retrospective analysis of records from 51,086 subjects seen at the Elaziğ tuberculosis dispensary (1985-1989).
• Evaluation of diagnostic, follow-up, preventive, and therapeutic interventions.
• Assessment of case-finding methods, particularly mass screening.

Main Results:

• No significant year-to-year differences in interventions despite population growth.
• Gradual increase in tuberculosis cases lost to follow-up.
• Frequent use of mass screening, identified as the least effective case-finding method.
• Underutilization of tuberculosis dispensary services.

Conclusions:

• Current tuberculosis control programs require review and improvement.
• Recommendations include reallocating resources from mass screening, integrating dispensaries with hospitals, and implementing a computerized patient database.
• Enhanced strategies are needed to prevent tuberculosis resurgence, especially in developing countries.