I.アジア諸国の結核

This is a special lecture at the 46th Annual Meeting of the Japanese Society for Tuberculosis.<BR>Tuberculosis control policy of Asian countries should have been established on the basic condition that about 80% of population lived in rural area where the prevalence of tuberculosis was almost equal as in urban area and the number of inhabitant per one medical doctor was very large especially in rural area, and that the national budget for tuberculosis control was obliged to be limited.<BR>It was nat u ral that BCG vaccination was recommended as the first choice of the control program in this condition because it was least expensive, easy to carry out and most effective although immediate effect was hardly expected.<BR>Because of a considerable number o f escape from the reading of tuberculin reaction, direct BCG vaccination was recommended in these countries and it was revealed that there was no much trouble in side reaction in tuberculin positive persons. To answer the urgent problem to give immunization as early as possible, study on the simultaneous BCG vaccination with small pox vaccin was carried out and marked increase of the coverage of BCG vaccination of small infants has been attained especiallyin Taiwan.<BR>As to the case finding the study on the sputum examination of symptomatic patients, which was carried out at the National Research Institute of Tuberculosis, Bangalore, was explained and the usefulness of the method for the integration of case finding program into general health services was emphasized introducing a wide scale trial of this method in Tumkur district of South India.<BR>Treatment of infectious patients with symptome is important not only from epidemiological standpoint but also from psycological standpoint. It has an immediate effect to reduce infections sources and satisfies inhabitant's demand to be cured. But the treatment is the most expensive control program. So statistical thinking in the choice of place of treatment and regimen of chemotherapy was explained in connection with actual number of negative conversion of sputum, which would be attained by the given budget, introducing various studies on this subject. At the same time efforts to decrease the drop-out from treatment in the self administration of drugs and the studies on the regimens of chemotherapy, which were suitable for the treatment under supervision, were introduced.<BR>Waaler's cost-benefit consideration i n the combination of BCG-program and case findingtreatment program was demonstrated as one of the guide lines of establishing tuberculosis control program in these countries.<BR>At the end of the lecture it was emphasized that if Japan intended to cooperate to promote tuberculosis control of some of Asian countries, it should be done along the line of the policy which was already employed by respective country and should not be pushed according to the view of an old-fashioned specialist without recognizing modern policy of the control of tuberculosis.