[Could tuberculosis again be an endemic disease in Hungary? (Model study 1968-1993)]

The aim of this examination started in an industrial district of Budapest with 100,000 inhabitants in 1968, was the determination of risk groups of pulmonary tuberculosis and the organisation of X-ray screening. The initial decrease in the incidence of pulmonary tuberculosis stopped (between 1981 and 1993) and, a minimal increase could be even demonstrated in the last years. The cause of the increase is explained by sociological factors (the influx of refugees, growth in the number of homeless people and of chronic alcoholics). The authors propose the modernization of the preventive and exploratory medical work: the use of computers in the lung-screening center and the institutionalisation of screening aimed at risk groups of pulmonary tuberculosis. In the population over forty years of age 92% of 408 new pulmonary tuberculosis patients, emerged from risk groups between 1981 and 1993, and only 8% from people who did not belong to the risk groups. The effectiveness of screening in the risk groups was 3 to 4 times higher than that of indiscriminate screening.