[Unknown pages of the history of Soviet tuberculosis service].
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Biomedical subjects
Publications and source records attributed to L P Kapkov.
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The authors share their experience in introducing the WHO tuberculosis-controlling recommendations adapted to the Russian conditions into the Republic of Mariy El, in the Ivanovo, Oryol, and Tomsk Regions. All the areas are marked by high rates of diagnosis of MBT in the clinical diagnostic laboratories of the general medical network, by the increased rates of detection of patients of tuberculosis who isolate Mycobacterium tuberculosis, by the enhanced efficiency of treatment of patients with tuberculosis, as shown by the Russian statistical data, by the lower rates of growth of the contingents of patients with tuberculosis or by their reduction.
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An unfavorable epidemiological trend in tuberculosis morbidity and mortality has been registered in the last decade. The number of newly detected cases and mortality in 1997 vs 1991 rose more than 2-fold reaching 73.9 and 16.7 per 100,000, respectively. The effectiveness of tuberculosis treatment is worsening: bacterial discharge stopped in 72.6%, destruction cavities in the lungs closed in 62.6%, clinical recovery was obtained in 17.2% of patients (relevant statistics for 1986 were 89.9, 81.6 and 21.9%, respectively). To correct the situation, government of the Russian Federation has adopted the program of tuberculosis control for 1998-2004. The Health Administration of the Ivanovo and Tomsk Regions has successfully introduced the DOTS program. Now, this positive experience is applied in other regions and institutions.
Due to the fact that the concept of detection of tuberculosis mainly using fluorographic studies have been long existing in Russia (for about 40 years), the general practitioners have lost their skills in differentiating tuberculosis from other lund diseases, eventually leading to its late diagnosis and a higher proportion of advanced tuberculosis cases. Recommendations are given how to involve general practitioners in detecting patients with tuberculosis actively.
The changed socioeconomic conditions require that a new concept of management of antituberculous measures be established. This includes measures, such as to set up interdepartmental tuberculosis control commissions, to adopt a law on protection of the population from tuberculosis, to transit from extensive to intensive methods of detection and treatment of tuberculosis, and requires a monitoring system for antituberculosis measures, regular supply with antituberculous drugs, and a medical educational system. The government must be the leader to control tuberculosis. Publicity should be at all stages of antituberculous activities.
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Questionnaires were distributed among all the heads of regional antituberculous services in Russia as to cases of tuberculosis among medical personnel in contact with tuberculous patients. The results of this study as well as programs to control tuberculosis in medical personnel are presented. Special measures of social support for those at occupational risk of tuberculosis are detailed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Explore the source record for details and available documents.