This article presents retrospective data from a ten-year material consisting of 426 patients with tuberculosis. There was a large difference in age between Norwegian and foreign patients. Median duration of symptoms before treatment was 15 weeks. The most common extrapulmonary form was lymph node tuberculosis, with a striking overpercentage of females. General symptoms were more common among patients with pulmonary tuberculosis than among patients with extrapulmonary forms. In 43% of the patients with pulmonary tuberculosis no abnormal signs were registered by auscultation. Febrile patients became quickly afebrile after start of treatment. 83% of the patients were tb culture-positive. 9.5% of the isolates tested for resistance showed reduced sensitivity to one or more antituberculous drugs. Chest x-ray manifestations were more common in the right than in the left lung. Older people are the main source of tuberculosis in Norway. One should be particularly aware of this diagnosis in immigrants from the Third World.
A total of 1150 cases of new-onset pulmonary tuberculosis were analyzed. A higher liability to the disease was shown in young females and males of ripe age. There was evidence for that the severer pattern of clinical forms and the nature of the process were directly proportional to the age of patients. Age-specific differences were found in the ways of detecting the disease and in the regularity of control fluorographic studies. The inclusion of persons aged 60 years or older into an increased risk group was justified. A severer pattern of clinical forms and characteristics of the process were established in males, which are largely caused by that the latter had irregularly underwent control fluorographic studies. Age- and gender-specific features of tuberculosis, which are typical of this region, have been identified.
The designing of an integrated information system of a tuberculosis dispensary (TD) has resulted in the construction and introduction of a model that is based on the concept of a uniform patient card, combines information on dispensary registration (DR) and striking off, as well as on the shifting of the TD-attached contingents between different DR groups. The system also contains a logic group that includes formalized descriptions of a tuberculous process. In addition, this model serves to integrate geoinformation technologies, as other information technologies (such as digital image acquisition, postprocessing, storage, and transmission) into its based information systems. This integrated information system permits a real-time quantitative analysis of the basic indices of the tuberculosis epidemic situation, which is necessary while planning tuberculosis-controlling measures, controlling their implementation, and correcting them at all levels.
Analysis of antituberculosis care to the Chukotka Autonomic District population in 1994-1999 suggests that despite economic difficulties, there was a continuous reduction in the major tuberculosis parameters. This may be accounted for by inadequate detection of tuberculosis among aborigines and by low contacts with comers. The resources created in the past years have been exhausted and, if urgent measures are not taken, there will be a rise in tuberculosis morbidity rates in the district.
In present epidemiological and economic conditions tuberculosis suspects should be hospitalized to specialized tuberculosis hospitals only after they are carefully examined for cancer of the lungs and lingering pneumonia. For this an obligatory diagnostic minimum should be introduced.
In Denmark tuberculosis is rare, with 7.3 cases per 100,000 inhabitants. In regions with few cases, lack of expertise may result in delay in diagnosis, improper treatment, and insufficient contact tracing. We suggest that tuberculosis is dealt with in one centre in each of the five regions in Denmark. LTOT is initiated and controlled by pulmonary specialists in 50% of cases only. Correct indication and follow up is better for patients who received LTOT by pulmonary specialists with a higher patient compliance. We conclude that LTOT should be centralised and treated by pulmonary specialists only.