[The problems of sanatorium care for tuberculosis patients].
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Biomedical subjects
Publications and source records attributed to M S Dvoĭrin.
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The levels of tuberculosis morbidity in the areas of a strict radiation control imposed as a consequence of the accident at the Chernobyl atomic power station are determined by the following two factors: outflow of young people (including children) whose tuberculosis morbidity is rather low; and lesser coverage of the population by preventive fluorographic examinations. In the majority of the areas of a strict radiation control, lesser coverage of the population by preventive fluorographic examinations has a predominant influence on the tuberculosis morbidity rates which appear to be lower than in 1985. At the same time the percentage of the destructive forms in newly diagnosed patients with respiratory tuberculosis happens to increase, while the proportion of those developing focal pulmonary tuberculosis appears to decrease. Tuberculosis case-finding is the urgent problem which should be achieved by means of non-radiation methods of detecting this disease.
State-of-the-art of antituberculosis care of the rural population in the Ukrainian SSR can be defined by advances in phthisiology. However, social, living and demographic factors as well as remoteness of specialized care for the rural population make it less effective than that for urban population. It seems possible to improve the antituberculosis care of the rural population by taking a number of measures at the level of the USSR Ministry of Health (to modify specifications, to improve supply with materials and equipment at the district level (to set up inter-district dispensaries, to centrally manage mobile fluoroscopy units, etc.); to better use available diagnostic and treatment means; and to improve prevention activities made by the general-purpose health institutions.
The problem of patients who returned from other territories and were previously observed in other tuberculosis institutions is analyzed. Their number is gradually increasing. With an example of some tuberculosis dispensaries of Kiev where registration of persons from other territories is limited it was shown that 88 per cent of the patients lived in Kiev: 47.5 per cent of them were intracity migrants and 52.5 per cent were persons who returned to Kiev after living for prolonged periods in other territories. The two groups of the patients markedly differed by their social and clinical status. There were more troubles with the group of the patients who arrived after living for prolonged periods in other territories since the greater proportion of such patients included discharged prisoners, heavy alcohol drinkers and patients without compliance with their therapy. Low treatment efficacy of such patients required special approaches. Respective proposals are presented.
Characteristics of the tuberculosis incidence in the Ukrainian SSR since the beginning of the wide use of antibacterial therapy were studied. It was shown that the delayed decrease in the incidence of tuberculosis in young persons observed lately did not correlate with further improvement of the epidemiological situation with respect to tuberculosis. It was indicated that the phenomenon stemmed from insufficient control of heavy alcohol drinking and alcoholism in the population and tuberculous patients.
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