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Biomedical subjects

V V Punga

Publications and source records attributed to V V Punga.

At least 19 recordsLinked to original sources
PubMed2006

[Calculation of a risk for death due to tuberculosis in case of the Sverdlovsk Region].

Many factors influence the risk of death in patients with tuberculosis. The most significant factors are a clinical form of the disease, combinations, comorbidity, age, and the duration of death. The risk of death averaged 4.2% in patients with new-onset tuberculosis, 30.4% in those with recurrent tuberculosis, and 6.4% in the registered. In patients with new-onset tuberculosis, the highest risk of death was established in tuberculous meningitis, miliary tuberculosis, fibrocavernous tuberculosis, and complications of tuberculosis (such as hemorrhage, spontaneous pneumothorax) increased the risk of death by almost 10 times (40.2%) and progression of HIV infection to AIDS by 7 times. The risk of death was increased up to 9.2% in primary multidrug-resistant pulmonary tuberculosis and by 12.7% in acquired one.

Adolescent↗
PubMed2006

[The results of work and experience of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas in controlling, detecting, and treating tuberculosis (a cohort analysis)].

In the Russian Federation, the WHO program was launched in 1994 and it covered the whole country by 2005. Detection and therapeutic efficiency are suboptimal. The proportion of pulmonary tuberculosis averages 34.5% (21.0-61.0%). In terms of cessation of bacterial isolation, therapeutic efficiency averages 61.4% with a scatter of 37.4-75.0%. Social support has a considerable impact on the efficiency of treatment.

Academic Medical Centers↗
PubMed2005

[Impact of tuberculosis morbidity on the health indices of a special contingent of the reformatory system].

The reformatory system of the Ivanovo Region shows a tense epidemic situation due to tuberculosis that heads the list of morbidity and ranks second in mortality in the region. 90-92% and 8-10% of new cases of tuberculosis occur in the reformatories and solitary confinements, respectively, the intracell morbidity in the solitary confinements being not more than 8.5-9%. Regular semiannual fluorographic examinations reveal that in the pattern of clinical forms of tuberculosis, its prevalent "small forms" (focal tuberculosis and infiltrative tuberculosis of 1-2 segments of one lung without decay) are prevalent.

Health Status Indicators↗
PubMed2005

[Formation of the rate of mortality due to active tuberculosis in the areas in the charge of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences].

Some areas in the charge of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, is marked by an increase in the morbidity rate among the residents from 1% in the Republic of Mordovia to 10.7% in the Ulyanovsk Region and by a decrease in the territorial rate. In 6 of 15 areas, tuberculosis mortality tends to increase, which is indicative of the strained tuberculosis epidemic situation in these areas. The rates of the proportion of patients who had died from active tuberculosis among those with new-onset tuberculosis, the deceased who had been followed up for as long as a year, and those who had not been followed up, which reflect the state-of-the-art of therapeutic and diagnostic work were studied.

Follow-Up Studies↗
PubMed2004

[Impact of introduction of the WHO tuberculosis-controlling recommendations adapted to the Russian conditions on the Russian statistical tuberculosis data].

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.

Guidelines as Topic↗
PubMed2003

[Organization of tuberculosis-controlling work and its efficiency in the penitentiaries of the Ivanovo Region].

The incidence rate of tuberculosis is high in the penitentiaries of the Ivanovo Region and in 2000 it was 32 times greater than that in the Region (3122 versus 96.7 per 100,000). Fluorography remains to be the main method of detection of pulmonary tuberculosis. It is performed on day 3 of admission of jail, then every 6 months. Fluorography allows one to identify 85-90% of the patients with pulmonary tuberculosis. In the fluorgraphic interval, the sputum from patients with symptoms of suspected tuberculosis is tested by the Ziehl-Neelsen procedure, which makes it possible to detect more than 15% of the tuberculosis patients who isolate bacteria. The patients are treated with the routine regimens including 4 first-line drugs. In 1997-2000, the rates of bacterial isolation session and decay cavity closure were in the range of 82.1-93 and 66.7-87.5%, respectively. Integration with civil tuberculosis service, the social security administration of the region, and the regional branch of the red-cross society has proved to be highly effective. The proportion of patients with tuberculosis who continued their treatment in tuberculosis facilities after release increased from 51.1% in 2000 to 80% in 2001.

Communicable Disease Control↗
PubMed2002

Frequency of recurrence among MDR-tB cases 'successfully' treated with standardised short-course chemotherapy.

SETTING: Ivanovo Oblast, Russian Federation, 300 km north-east of Moscow, where a pilot DOTS TB control programme was implemented in October 1995. OBJECTIVE: To determine the frequency of TB recurrence among MDR (multidrug-resistant) patients who achieved treatment 'success' on standard short-course chemotherapy. METHODS: All patients with MDR tuberculosis, defined as resistance to at least isoniazid and rifampicin, who were declared 'cured' or 'treatment completed', were identified using the district register and traced whenever possible. Eligible patients underwent medical examination and, if necessary, chest radiography, sputum smear examination, culture and susceptibility testing. If the patient had died, the relatives were interviewed to try to determine the reasons for death. RESULTS: Of 18 patients eligible for analysis, five (27.8%) were documented to have recurrence (two of seven patients resistant to HRSE, one of five patients resistant to HRS and two of six patients resistant to HR). Patients receiving the Category I regimen were more likely to relapse than those receiving the Category II regimen (40% vs. 12.5%). The median time to relapse was 8 months; 2.46 recurrences were observed in 100 person-months (3.17 in category I and 1.3 in Category II patients). CONCLUSIONS: The frequency of TB recurrence among MDR-TB patients declared 'cured' after short-course chemotherapy is high. Improvements in treatment success, after removal of programme-related pitfalls in the treatment delivery process, must incorporate methods for early detection of MDR, along with adequate treatment regimens including second-line drugs. Culture-based bacteriological confirmation at the end of treatment is recommended.

Adult↗
PubMed2001

Tuberculosis in Russia and the problem of multiple drug resistance.

Tuberculosis cases in Russia doubled from 1991 to 2000, when the incidence reached 90 per 100,000; and Russian TB mortality rates are the highest in Europe. Implementation of WHO-recommended DOTS strategy is in the preliminary stages. The epidemiological data are presented as is the implementation strategy for stabilizing the epidemic.

Drug Resistance, Multiple↗
PubMed2001

[Effectiveness of WHO strategies in prisons in the Ivanovsk district].

The paper analyzes the results of implementation of the WHO recommendations on detection ad treatment of patients with tuberculosis in 1997-1999. A total of 8901 individuals with symptoms of suspected pulmonary tuberculosis were examined in this period. Sputum smear microscopy revealed acid-resistant bacteria (ARB) in 293 (3.3%) of the patients, including in 167 (57%) with their verification at clinical diagnostic laboratories of general health care units. A therapeutical success was achieved in 81.9% of the new cases of pulmonary tuberculosis who had ARB, in 85.7% of the patients without ARB, and in 72% with recurrent tuberculosis.

Efficiency, Organizational↗
PubMed1999

[Tuberculosis in Russia].

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.

Communicable Disease Control↗
PubMed1998

[Cost benefit of detection and treatment patients with tuberculosis in Ivanovo region, Russian Federation].

To execute the tuberculosis control programme in the Ivanovo Region, the authors calculated the cost of detection of a tuberculosis case at patients' referrals to a therapeutical-and-prophylactic institution for medical aid and during prophylactic X-ray fluographic examinations and the cost of tuberculosis cure while treating the patient at a hospital in the intensive treatment phase (2-3 months) and in the outpatient setting or at a day hospital by the intermittent method in the continued treatment phase. The costs calculated were compared with those obtained by early approaches. The cost of detection of a tuberculosis case was 1580.8 for referrals in 1996 and 4000 for X-ray fluographic prophylactic examinations. The costs of hospital tuberculosis cure (85% cure rates) only in the intensive treatment phase (for 2-3 months) and outpatient intermittent treatment (for 2-4 months) with and without meals were 2415.34 and 2142.17 respectively. If the efficiency is equal, the introduction of new approaches to organizing the detection and treatment tuberculosis cases may save 3877.7 for each cured tuberculosis case and 2419.2 for each patient detected.

Ambulatory Care↗
PubMed1998

Cost-effectiveness analysis of tuberculosis control policies in Ivanovo Oblast, Russian Federation. Ivanovo Tuberculosis Project Study Group.

Many of the current tuberculosis control programmes in the Russian Federation are based on costly strategies which are underfunded and use long, individualized treatment regimens. This article compares, using a cost-effectiveness analysis, the new WHO strategy implemented in the Ivanovo Oblast (case-finding among symptomatic patients (SCF) and shorter regimens) and the old strategy (active screening of the asymptomatic population (ACF) and longer regimens). The cost per case cured was calculated at different levels of cure rate (45-95%) using three scenarios to describe the new WHO strategy (use of WHO-recommended regimens and three options at increasing rates of admission) and a fourth scenario to describe the old strategy (all patients admitted for the whole treatment and longer regimens). The cost per case detected was determined by calculating the following: yield of the new and old strategy (number of examinations necessary to diagnose one case); cost of the diagnostic process; multiplying yield per cost according to the three scenarios describing the new WHO strategy and a fourth scenario describing the old strategy. In the Ivanovo Oblast the cost per case cured, at 85% cure rate level, ranged from US$ 1197 (new strategy, scenario 1 without food) to US$ 6293 (old strategy, scenario 4) the cost per case detected ranged from US$ 1581 (new strategy, scenario 1) to US$ 4000 (old strategy, scenario 4). Significant savings can result from shifting towards the new WHO strategy. Decision-makers and health administrators should be responsible for re-investing the financial and human resources mobilized by the adoption of cost-effective strategies within the TB control programme.

Antitubercular Agents↗
PubMed1997

[Trends in tuberculosis epidemiology in the Ivanovo Region and its stabilizing measures].

In 1993-1995, tuberculosis morbidity increased from 37.8 per 100,000 inhabitants to 55.7. The increase was due chiefly due to incidence rates among urban dwellers. In the same period, tuberculosis mortality rose from 10.2 to 55.7 per 100,000. Tuberculosis control strategy has been revised under the conditions of the increasing spread of tuberculosis infections and the Central Research Institute of the Russian Academy of Medical Sciences jointly with the WHO Global Programme Department has developed the programme "Detection of Patients Isolating Mycobacterium tuberculosis by the ??Tsil-Nilsen method and Their Short-Term Chemotherapy". Analyzing the preliminary data available during 2 quarters (Quarter IV, 1995, and Quarter I, 1996) indicated its adequate efficiency.

Communicable Disease Control↗
PubMed1997

[Present-day problems of detection and patient treatment with tuberculosis].

The problems of detection and treatment of patients with tuberculosis, which are of paramount importance for today, are presented through the analysis of the tuberculosis epidemic situation in the country and of the sociomedical characteristics of new cases (49% of socially disadapted persons). Of the most significance is the need to promptly identify patients with strains on their referral to the general somatic hospitals for complaints by using 3-multiple sputum bacterioscopy for Mycobacterium tuberculosis by the Ziehl-Neelsen method. The vital problem is also to change chemotherapeutical regimens as more severe progressive types of the disease require more active treatment in the first months after detection especially in the cohort of socially disadapted persons.

Antitubercular Agents↗
PubMed1997

[Sociomedical aspects of detection and treatment of patients with tuberculosis under present conditions].

By analyzing the present-day tuberculosis epidemiological situation in the country and sociomedical characteristics of new cases, the authors present methods for detecting and treating patients, which are of paramount importance for today. Of the most significance is the need to promptly identify patients with strains on their referral to the general somatic hospitals for complaints by using 3-multiple sputum bacterioscopy for Mycobacterium tuberculosis by the Ziehl-Neelsen method. The vital problem is also to change chemotherapeutical regimens as more severe progressive types of the disease require more active treatment in the first months after detection especially in the cohort of socially disadapted persons.

Adolescent↗
PubMed1996

[Tuberculosis in refugees from foreign countries].

Screening for tuberculosis has revealed active disease in 30 of 168 examinees. They have arrived in Russia as refugees from Somalia, Afghanistan, Angola and other countries. 24 refugees had pulmonary tuberculosis. Destruction of pulmonary tissues and massive discharge of M. tuberculosis were found in 10, 2 and 1 patients with infiltrative, disseminated and fibrous-cavernous tuberculosis. A specific therapy with 3-4 drugs stopped discharge of the bacteria with sputum. It is stated that refugees from foreign countries may constitute a great epidemiological threat of tuberculosis for contacting Russian population.

Adolescent↗