Tuberculosis control in lower Franconia 1995 - 2001. Case-finding and treatment outcome

How useful is active case-finding for the controlling of tuberculosis (TB) in Lower Franconia? What treatment outcome is being achieved and which factors reduce this success? All 867 TB cases reported to the public health departments in Lower Franconia between 1995 and 2001 were used as anonymous data for a prospective study. Average age, gender, country of origin and rates of bacterial resistance of the patients coincided to a large degree with the data of the DZK study. The percentage of resettlers from the former Soviet Union with TB was, however, almost double. Therapeutic success was reached in approx. 79 % of the contagious TB and thus surpassed the rates of published investigations slightly. A negative impact upon the treatment outcome was caused by the following circumstances: A number of asylum seekers disappeared into illegality before the treatment was completed; certain TB-patients stopped taking the medication after surgical removal of the focus; only half of the sick persons who died of the disease were diagnosed when still alive. Active TB case-finding is useful mainly among asylum seekers and resettlers. An improvement of the treatment outcome in Lower Franconia is desirable but appears to be only possible within strict limits.