[Evolution of chronic pulmonary tuberculosis and the possibility of preventing chronicization (in the Iaşi judicial...

The instantaneous prevalence of patients with pulmonary tuberculosis has been evaluated; the patients were included in the dispensarization group I between 1974 and 1980. Initially there was a decrease of the prevalence of the patients in Group I B but over the last years this was stable at 11.7-13.5 0/0000 inhabitants. The decrease which had been obtained at first was due to the immediate effect of repeated treatments with new tuberculostatic drugs resulting in sterilization and inclusion in the Group II of dispensarization of many of the preexisting patients while the ceiling which occurred later was determined by the quantitative balance of therapeutic failures and relapses entering the Group I B and cases which left the Group as a result of medical solutions, death or change of address. It was also noted that most of the patients in whom presence of the bacilli had been determined by microscopic techniques and by cultures constituted a relatively stable group over the entire period of the study, and oscillated between 11 and 17.5%, and 56.5 and 65.9% respectively. The quantitative balance established over the last years between the "entrances" and the "exits" from Group I B may be altered firstly by lowering the number of failures and relapses after the first treatment. The nature of unfavourable factors which influence the prognosis may be classified as follows: bio-psycho-social implications (males--81.5%, age--between 30 and 50 years, 51.4%, lack of occupation, 31.5%, low educational level, 80.1% chronic ethyl intoxication 51.4%, psychoses, 12.7%, other associated diseases, 34.3%, and primary drug resistance, 7.1%); consequences of a late detection; deficiencies in the rhythm and the duration of the first treatment with tuberculostatic drugs (non-cooperation--64.2%, irregularities--38.5%, interruptions--42.8%, secondary drug resistance--14.2%).