[Model for the treatment of cases of chronic pulmonary tuberculosis in the Vîlcea district].

Patients with pulmonary tuberculosis are considered to be chronic cases when they continue to eliminate bacilli after one year after registration and start of treatment. The chronic cases are classified in the I B dispensary group. Following the introduction of the chemotherapy program the number of chronic patients with tuberculosis has dropped appreciably after 1974. However the rate of decrease has diminished between 1978 and 1979. In view of evaluating the possibilities for recuperation of chronic patients a research was organized in several districts. In one of them, the Vilcea District, it was noted that in spite of the fact that each year a large number of patients from group IB are eliminated, either following negativation of their sputum examinations, or by death, the total number of patients in the group itself does not decrease, since it is continuously fueled by failures of the initial treatments, and by relapses in the first two years after the end of the treatment. The analysis of the chronic cases in evidence on the 1-st of January 1980 showed that there are possibilities for recuperation by chemotherapy in 44,8% of the patients, and by surgery in another 9,5%. Only 23,8% are considered as non-recuperable. The authors review the technical and organizational measures which are indicated in view of solving the existing cases, and for the prevention of other chronicization. The short-term prognosis indicates the possibility for reducing the prevalence of chronic patients by more than 50% over a period of 3 years.