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國立益山病院 癩患者의 疫學 및 社會醫學的考察

Epidemiological and Socio-medical observation on Leprosy patients of the National Ik-San Hospital (Leprosarium), Ik-San-Gun, Cholla-Pukdo, Korea

최신의학 1962년 5권 10호 p.109 ~ 120
황기석,
소속 상세정보
황기석 (  ) - 수도의과대학 예방의학교실

Abstract


The author carried out epidemiological observations on leprosy patients accommodated at the National Ik-San Leprosarium. The survey was conducted during the period from September, 1961 through August, 1962 and the following conclusions were noted :
1. The sex ratio(male/female) was 1.2/1, and the distribution of in patients by their native provinces was : Cholla-Namdo and Pukdo 86.3%, Kyongsang-Namdo and Pukdo 6.7%, Chung-Cheong-Namdo and Pukdo 6.1% and others less than 1%.
2. As to their occupation and educational background, 45.0% of them were unemployees included women from rural area, 43.6% of them were engaged in farming, and 28.0 of the patients were so illiterate as to merely understand the Korean alphabet and those with higher educations were very rare.
3. Periods from onset to hospital admission varied markedly. 15.0% of the patients spent a year prior to admission, 8.7% 2 years, 7.0% 5 years and very few spent more than 30 years. The duration of their hospitalization was from 1 to 13years were in the majority, occupying 12.1% of the total cases.
4. The family history of these patients indicated that 34.0% of the cases came from leprous back-grounds and 66.0% of the remainder did not. 13.0% of those came from infected families had also leprosy among their brothers or sisters.
5. As to the age of onset, the age group of 15 to 19 years were highest incidence 31.3%, and the group from 20 to 24 years subsequently occupied 10.2% of total. The youngest age group was from 0 to 4 years, which occupied 0.3% and the oldest age group was from 50 to 59 years, or 1.1%.
6. The initial symptoms were the alteration of sensation of invaded sites which appeared in 71.7% of the entire cases. There were skin ulcerations in 6.0%, leucoplakia in 4.7%, nodules in 4.4%, vesicles in 3.5%, erythema and edema in 2.8% each and the lepromatous type was 2.5 times higher than the non lepromatous type when these were classified in accordance with standard. The initial lesions were observed in the lower extremities in 52.3%, the upper extremities in 27.3% and the face in 10.2%.
7. Investigating their home medication prior to admission, it was found that 63.5% of the cases had used sulfon drugs, and 8.4% herb medicines.
8. Classifying the current status of the leprous type of 884 cases at the time of survey, it was found that the lepromatous type(L) was 72.0% and non-lepromatous type 28.0%. It was also revealed with Wade´s method that 38.3% of the total cases were bacteriologically positive while 61.7% were negative.
9. A check on admission records, in relation to the direct causes of death for inpatients during the past 11 years(1951^-1961), indicated that among a total of 124 deaths, 25.0% were due to so-called "leprous
emaciation", and 15.3% each were due to hepatic and pulmonary tuberculosis. 13.7% of all deaths were in the age group from 45 to 49 years of age showing a higher frequency than other age groups. It was also noticed that 57.3% of all deaths were from the lepromatous type and 42.7% from the non-lepromatous type.
10. The length of the disease period from the time of onset to death was; 15 to 19 years duration accounted for 19.3 % of all deaths, 20 to 24 years 17.7 %, 30 to 34 years 15.3 %, and the shorter period less than 4 years was 0.8%. The average case fatality rate of all cases during the past 11 years was 0.9% respectively.

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