Tuberculosis trends in eastern Europe and the former USSR.

The aim of this paper is to assess trends in tuberculosis morbidity and mortality in the countries of Eastern Europe and the former USSR. Data on morbidity and mortality were obtained from reports of the Ministries of Health, a 1992 WHO questionnaire, national tuberculosis associations, and other sources. The quality of surveillance of tuberculosis cases differs widely between countries.

Cost-effectiveness of chemotherapy for sputum smear-positive pulmonary tuberculosis in Malawi, Mozambique and Tanzania.

The cost-effectiveness of chemotherapy for pulmonary sputum smear-positive tuberculosis was examined in the national tuberculosis control programmes of Malawi, Mozambique and Tanzania. In these three programmes, routine cure rates have exceeded 80 per cent. Average, average incremental and marginal unit costs for standard, short-course and retreatment regimens with and without hospitalization have been measured.

[BCG vaccination in West Germany?].

It is evident from follow-up studies of tuberculosis in the Netherlands (without BCG vaccination), Sweden (discontinuation of BCG vaccination since 1975) and in both parts of Germany (FRG discontinuation since 1975), as well as from the favourable tuberculosis situation in both parts of Germany (low tuberculosis incidence and very low infection risk) that general vaccination of babies is no longer warranted. For this reason the German Central Committee for Combatting Tuberculosis is considering in consultation with the Federal Bureau of Health to abstain from continuing to recommend general BCG vaccination of all newborn. BCG vaccination should be recommended only in enhanced-risk groups (children of foreign parents and children sharing their living quarters or household with a person suffering from acute, i.

Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries.

The value of programmes to control pulmonary tuberculosis in developing countries remains the subject of debate. We have examined the cost-effectiveness of chemotherapy programmes for the control of pulmonary sputum-smear-positive tuberculosis in Malawi, Mozambique, and Tanzania. Effective cure rates of 86-90% were achieved with short-course chemotherapy and of 60-66% with standard chemotherapy.

The impact of HIV infection on the global epidemiology of tuberculosis.

HIV is the strongest risk factor for tuberculous disease observed in the last 100 years in subjects infected with tubercle bacilli. Its impact upon tuberculosis incidence is so great that it has disrupted the balance between the tubercle bacillus and the community. The breakdown rate from tuberculous infection to active tuberculosis in persons infected dually is at least 30%.

The global aspects of tuberculosis and HIV infection.

HIV infection is the only factor which has been able to disturb the balance between the tubercle bacillus and man, in the absence of man-made interference. The impact of HIV infection on the epidemiological situation of tuberculosis is so large that, under certain conditions, the tools available at present for tuberculosis control will fail to restrain the increase in the incidence of tuberculosis caused by HIV infection. It is to be seen to what extent an efficient control programme in developing countries will be able to contain the transmission of tuberculosis infection, in particular the risk of tuberculous infection.

[Possible effects of acquired immunologic deficiency syndrome (AIDS) on tuberculosis in industrial and developing countries].

Tuberculosis is the most frequent infectious complication of AIDS and HIV infection in countries where che prevalence of tuberculous infection is high. HIV infection is the strongest risk factor for developing tuberculosis in individuals infected removly or recently with tubercle bacilli. An increased incidence of tuberculosis has been already documented in several African countries with a high prevalence of both tuberculous and HIV infections (Tanzania, Malawi).

Tuberculosis control in refugee settlements.

Tuberculosis and its management in refugees and other displaced persons in temporary settlements poses a challenge to organisations coordinating and providing care in refugee emergencies. This paper offers a consensus of the co-sponsoring agencies on practical recommendations for implementing measures aimed at both interrupting transmission of tuberculosis and treatment of individual patients.

Overview and epidemiologic assessment of the current global tuberculosis situation with an emphasis on control in developing countries.

The global epidemiologic situation of tuberculosis is reviewed, with emphasis on the disappointing achievements in its control in developing countries over the last three decades. In developed countries where prevalence of tuberculosis is low, it will take at least 30-50 years to eliminate the disease because of exacerbation by individuals who acquire infection abroad. In developing countries, 2-3 million deaths will occur among the estimated 4 million new smear-positive and 4 million new smear-negative and extrapulmonary cases of tuberculosis.

Overview and epidemiological assessment of the current global tuberculosis situation: with an emphasis on tuberculosis control in developing countries.

This paper reviews the global epidemiological situation to tuberculosis, with an emphasis on the disappointing tuberculosis control achievements in developing countries over the last three decades. It is concluded tht in low prevalence developed countries it will take at least 35-40 years to eliminate tuberculosis because of endogenous exacerbation in subjects remotely infected. In developing countries most of the estimated 4 million new smear-positive and 4 million new smear-negative and extra-pulmonary cases with some 2-3 million deaths from tuberculosis occur each year.

Surveillance of diagnostic and treatment measures in Bavaria, 1974-1976. Results 2 and 5 years after the start of chemotherapy.

A central surveillance register for all bacillary pulmonary tuberculosis cases reported in Bavaria (population in excess of 10 million) was established from 1974 to 1976. The aim of the study was to discover the quality and efficiency of health services delivery to the population in the field of tuberculosis under routine conditions, and to find out the relapse rate after cessation of chemotherapy in expatients who were found to be negative 2 years after starting chemotherapy. A total of 7850 German patients with bacillary pulmonary tuberculosis were diagnosed in Bavaria from 1974 to 1976 corresponding to an average annual rate of 25.

Osteotomy for kyphosis in ankylosing spondylitis.

Twenty-two patients suffering from progressive kyphosis due to ankylosing spondylitis underwent one or more lumbar osteotomies during 1957-1983. The primary thoracic kyphosis was 80 degrees (45 degrees-155 degrees). The mean correction obtained by one level osteotomy was 44 degrees (30 degrees-60 degrees).

The yield of active case-finding in persons with inactive pulmonary tuberculosis or fibrotic lesions. A 5-year study in tuberculosis clinics in Amsterdam, Rotterdam and Utrecht.

The aim of the study was to elucidate the yield of annual chest X-ray and bacteriological examination in subjects with inactive tuberculosis or fibrotic lesions. Nearly 15 000 such persons registered at the Tuberculosis Clinics (C.B.