LIFELONG FOLLOW-UP OF INACTIVE TUBERCULOSIS - ITS VALUE AND LIMITATIONS

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Abstract
There are 14,552 inactive cases of tuberculosis in British Columbia, Canada, representing 0.6% of the population. The prevalence of inactive tuberculosis is 7 times higher among Indians than in the remainder of the population. Among all inactive cases, 60.5% of patients had good chemotherapy; 13.2% had poor chemotherapy and 26.3% had no chemotherapy. The risk of reactivation in those who received good chemotherapy was 2.2 cases/1000 persons per annum; for those with poor and no chemotherapy, the risks were 7.8 and 6.7 cases/1000 persons per annum, respectively. Of a sample of all inactive cases, 1/3 did not comply with the existing policy of lifelong annual examinations. Of the remaining 2/3, 1/2 attended regularly and 1/2, irregularly. All reactivations occurring during the 3-yr period 1971-1973 were reviewed. The pattern of attendance of these patients during a 3-yr period immediately before the year of reactivation was similar to that of the sample of all inactive cases. Of reactivations occurring among attenders, 60% were diagnosed at such annual examinations. The bacteriologic status of reactivated disease was reviewed; 78% were culture positive. Of patients who received previous chemotherapy, 45% had organisms resistant to 1 or more of the 3 primary antituberculous drugs; previously untreated groups showed a much lower figure, 7.8%. Recommendations are made in relation to future policy of management of inactive cases of tuberculosis.

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