[Therapy modalities used in tuberculosis in a French Department. The Bas-Rhin, 1965-77]

An analysis of treatment methods was carried out on 8,116 subjects suffering from all forms of tuberculosis, notified from 1965 to 1976 to the Bas-Rhin Tuberculosis Register and not kept in the active card index longer than the 31 dec. 1977 (because they were cured, dead or lost from sight). Only the cases of respiratory tuberculosis not bacteriologically proven notified during the first period (1965 to 1969) were not included in the study. In the annual cohorts the proportion of patients treated in hospital for more than 15 days, as cell as the mean length of hospital stay and duration of antituberculous chemotherapy, has considerably decreased. The drugs most often used for notified patients from 1965 to 1969 were Isoniazid, Streptomycin and P.A.S. For patients notified between 1970 and 1976, Rifampicin, Isoniazid and Ethambutol were most common. Triple therapy was used most often, 66,8% for the first period, 52.6% for the second. At the end of the second year of follow up the proportion cured rose from 26% of the cases surveilled for the first cohort (1965-1969) to 51% for the second (1970 to 1974) and 61% for the third (1975-1976). As for the death rate, this progressively declined from 4,3% to 2,4% and 1,6%. Finally the prevalence and incidence of bacteriologically proven tuberculosis has decreased strikingly in the general population of the Bas-Rhin since 1965. In addition there was a progressive diminution in the ratio of these two indices (2,4 in 1965 and 1,2 in 1979) conveying the real efficacy of these treatment regimes.