Фтизиатрия
RESULTS OF TREATMENT OF TB PATIENTS IN RUSSIAN FEDERATION IN 2018
Sterlikov S.A.1,2, Galkin V.B.3, Rusakova L.I.2, Ponomarev S.B.4, Gordina A.V.1
1. Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
2. Central TB Research Institute, Moscow
3. St. Petersburg State Research Institute of Phthisiopulmonology, St. Petersburg
4. Research Institute of the Federal Penitentiary Service, Moscow
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Summary:
Aim. The dynamics of the three components of monitoring the effectiveness of treatment were analyzed: registration for treatment and outcomes of individual courses of chemotherapy, the effectiveness of follow-up for patients and the elimination of an epidemically important trait - bacteriological excretion.
Materials and methods. Analyzed information from the forms of official statistical observations over the past 10 years. Used the methods of analysis of time series.
Results. There has been a decline in treatment success rate (for pulmonary tuberculosis - newly diagnosed and relapses) in I, II, III regimens in public and penitentiary health care to 70.6%, 55.5%, respectively. The increase in the frequency of successful treatment of tuberculosis in MDR regimes in public health to 54.7% is due to the improvement in the structure of patients, and its decline in penitentiary health care to 34.3% with an increase in the number of transferred out to 31.6%. Treatment success rate for XDR-TB cases in public health care increased to 38.4%. The rate of clinical cure for newly diagnosed patients with respiratory organs tuberculosis decreased to 46.6%, and the proportion of cured patients (excluding transferred) decreased to 45.0% with an increase in one-year mortality to 12.0%. The number of patients with tuberculosis who are in the follow-up for TB as at the end, and during the year, has significantly decreased. The proportion of clinically cured patients with pulmonary tuberculosis increased to 23.8%, patients with pulmonary tuberculosis without lung damage decreased to 26.5%. The abacillation rate rose to 51.2 per 100 annual average bacterial excreta. The proportion of patients who ceased bacteria excretion was 29.1% of all bacterial excreta observed during the year. The growth in the proportion of bacterial excreta that stopped bacterial excretion continued for patients with multidrug-resistant tuberculosis (to 20.0%), and for the rest of patients fell to 37.6%.
Conclusion. The dynamics of monitoring tuberculosis is mainly related to the process of improving the registration of patients (foreign citizens and homeless) for treatment in the public healthcare system, a decrease in the supply of anti-tuberculosis first-line drugs (with sufficient supply of second-line drugs), an increase in mortality due to co-infection with tuberculosis and HIV, advances in the treatment of tuberculosis with multiple and extensive drug-resistant pathogens, including those associated with the introduction of new anti-tuberculosis drugs. The introduction of a federal register of people with tuberculosis has not yet influenced the percentage of patients who was transferred out
Keywords monitoring of tuberculosis, outcomes of chemotherapy courses, treatment outcomes, results of follow-up, abacillation, cessation of bacteria excretion.
Bibliographic reference:
Sterlikov S.A., Galkin V.B., Rusakova L.I., Ponomarev S.B., Gordina A.V., RESULTS OF TREATMENT OF TB PATIENTS IN RUSSIAN FEDERATION IN 2018 // Scientific journal «Current problems of health care and medical statistics». - 2019. - №3;
URL: http://healthproblem.ru/magazines?textEn=271 (date of access: 21.11.2024).
URL: http://healthproblem.ru/magazines?textEn=271 (date of access: 21.11.2024).
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