[Treatment results of patients with bacteriologically confirmed tuberculosis registered in Poland in 1996]. / Wyniki leczenia chorych na gruzlice potwierdzona bakteriologicznie zarejestrowanych w Polsce w 1996 r.

Basing on the data from the Central Tuberculosis Register (existing since 1985), an analysis on the treatment regimens and outcomes was made in 7.919 (6.538 new cases and 1.010 recurrents) patients with active confirmed bacteriologically tuberculosis in 1996. After one year follow-up, among 7.919 patients: 371 were untreated (2.3%), 6.551 were cured (82.7%) (3 x 3 negative smears and culture examinations in the period of 6 months after last positive examination; and 386 were doubtful (4.9%)--i.e. patients in whom 1 x 3 or 2 x 3 negative smears and culture examinations were obtained after last positive examination. 676 patients (8.5%) died of which 418--(4.0%) due to TB; 121 patients--1.5% were still positive. In summary--87.6% of patients were cured or considered as completed treatment. In 1996 year 77.1% patients received four--drug regimens (INH, RMP, PZA, SM/EMB), 18.6% of patients received--3 drugs (in the majority INH, RMP, PZA) in the initial phase of the treatment. The treatment in this phase is, in the majority of cases, performed in hospital under supervision. In spite of the high efficacy of applied regimens, the duration of treatment was too long: 55.9% patients was treated longer than 6 months (32.8% > 9 months).

[Results of anti-tuberculosis treatment of patients with tuberculosis--children and adolescents treated in Poland in 1993]. / Wyniki leczenia przeciwpratkowego chorych na gruzlice dzieci i mlodziezy leczonych w Polsce w 1993 roku.

Treatment of 581 new cases tuberculosis in 215 children and 366 adolescents reported in 1993 were followed up for 12 months. The results show that 96.6% bacteriologically confirmed cases were cured (93.8% of children and 97.2% of adolescents). Among 409 bacteriologically negative cases (183 children and 222 adolescents) only in 7 (4 children and 3 adolescents) i.e. in 1.7% no radiological improvement was observed. 75.7% of cases BK+ received 4 drugs treatment regimen-85.4% adolescents and 40.6% children. Children with bacteriologically negative tuberculosis were treated with 2 drugs regimen -(53% of cases) and with 3 drugs regimen 43.2% of cases, while in adolescents majority of cases received 4 drugs (59.0%) or 3 drugs (33.8%). In almost all regiments there were INH and RMP. In spite of high efficacy of applied regimens, the duration of treatment was relatively long. In children BK+ , in 87.8% of cases it was longer than 6 months (in 43.8% of cases it was longer than 9 months). In adolescents BK+, in 81.2% of cases duration of treatment was longer than 6 months (in 34.7% it was longer than 9 months). Among cases BK(-), in 82.5% of children duration of treatment was longer than 6 months and 53.7% adolescents BK(-) were treated longer than 6 months.

[Effect of selected socio-economic factors on incidence and outcome of tuberculosis in Poland]. / Wplyw wybranych czynników socjalno-bytowych na wystepowanie i przebieg gruzlicy w Polsce.

The purpose of the paper was to verify the widely held opinion about the influence of socio-economic conditions on tuberculosis incidence and outcome. The analysis of the relationship between different socio-economic factors and tuberculosis shows that level of education seems to be the most important indicator. The level of education of tuberculosis patients in Poland is lower than the average. Together with the standard of living it differentiates patients with regard to clinical form of the disease-the lower the level of education and standard of living conditions, the more fibrocavernous forms. The analysis also indicated that the level of education and employment or unemployment did not influence the choice of treatment regiments but influenced the outcome of treatment.

[Characterization of patients with treatment failure in the Central Tuberculosis Registry]. / Charakterystyka chorych nieodpratkowanych w Centralnym Rejestrze gruzlicy.

An analysis was carried out in order to explain the reason of treatment failure in patients with bacteriology confirmed active tuberculosis registered in the Central Tuberculosis Register in the years 1988-1991. The population of patients is whom failure of treatment was observed is older compared with the population of patients in whom the treatment did not fail. The regimens in both groups were similar although the duration of the regimens was shorter in the group in whom tuberculosis was not eradicated (less than 3 months or the treatment duration could not be established). In the chronic sputum positive patients severer cases of tuberculosis were observed more often. Tuberculosis coexistent with other diseases was seen twice more often. The result of therapy in patients with bacteriologically confirmed tuberculosis can be effected by coexistency of tuberculosis and alcoholism.

[Tuberculosis in the central register for tuberculosis]. / Gruzlica w centralnym rejestrze gruzlicy.

Applied methods and results of antituberculosis treatment of all registered patients in 1990 in Poland are presented. Tuberculosis prevention was achieved in 91.9% of sputum-positive patients similarly, diagnostic mistakes were detected in 10% patients with non-bacteriologically determined tuberculosis. In one year since registration 7.7% of sputum-positive patients and 3.9% of patients with non-bacteriologically confirmed tuberculosis have been dying in one year since registration time. Majority of patients in Poland were treated too long because of tuberculosis.

[Case finding program for tuberculosis with special reference to chest x-ray examination]. / Wykrywanie chorych na gruzlice pluc ze szczególnym uwzglednieniem badan radiofotograficznych.

An analysis of tuberculosis case-finding programme in Poland in 1966-1991 was performed. The main methods applied in practice were--case-finding according to "symptoms" and according to results of "chest x-ray examination". About 90% of new cases were detected by above mentioned methods. Case-finding according to "symptoms" was increasing parallel to age of patients and reached 74% in group over 60 years. On the other hand, the efficacy of chest x-ray examination was decreasing parallel to age of patients one was calculated as 19%. The case-finding method according to "symptoms" is suggested by authors as a basic and useful, especially in family doctor's practice. Chest x-ray examinations should be limited to high risk population.

[Coexistence of pulmonary tuberculosis and alcoholism in Poland]. / Wspólistnienie gruzlicy i alkoholizmu w Polsce.

The aim of study was to determine a number of alcoholics in new diagnosed cases of bacteriological confirmed pulmonary tuberculosis in 1989-1990. Data were obtained from the Central Register of Tuberculosis. It was found that the number of alcoholics among new registered patients with tuberculosis increased from 8.8% to 10.5%. Young patients were more than 60% group. Results of treatment of severe types of pulmonary tuberculosis in alcoholics were also not so effective as in typical patients.

[The role of radiophotography in tuberculosis control programs in Poland]. / Miejsce badan radiofotograficznych w programie zwalczania gruzlicy w Polsce.

The role of mass radiophotography in Poland in the years 1985-1898 is presented basing on routine data from Antituberculous Centers and Radiophotographic Units. Mass radiophotography detects approximately 30% of new registered pulmonary tuberculosis cases. In the analysed period the number of radiophotographic examinations systematically fell. Also the percentage of the population that was screened using this method decreased, as well as, although to a lesser state, the percentage of new detected cases of pulmonary tuberculosis. A significant decrease in usage of mass radiophotography equipment was also seen. The economical cost of such examination increased. The role and place of mass radiophotography in tuberculosis control programs in Poland is discussed by the authors. It seems that first contact physicians will have the most pronounced role in early diagnosis of pulmonary tuberculosis. Also more emphasis should be placed on bacteriological diagnosis of tuberculosis.

[The role of diabetes as a factor for increased risk of infection with tuberculosis]. / Rola cukrzycy jako cznnika zwiekszonego ryzyka zachorowania na gruzlice.

The number of freshly registered sputum positive cases of pulmonary tuberculosis coexistent with diabetes mellitus was calculated from data of the Central Register of Tuberculosis in Poland. The incidence rate for this group in 1985 and 1986 was only 2.6%, while the calculated rate was only higher by 1/3 in comparison with rates of the general population. This leads to a conclusion that diabetes mellitus does not increase the risk of developing tuberculosis. Treatment did not differ from standard therapeutical regimes. Early results were comparable with those from a general population. The mortality rate analyzed in both years was three fold higher in the group with coexistent diabetes mellitus than in the general population treated for tuberculosis. This implies that tuberculosis coexistent with diabetes mellitus is a great clinical problem but epidemiologically is insignificant.