The New Profile of Drug-Resistant Tuberculosis in Russia A Global and Local Perspective: Summary of a Joint Workshop by the Institute of Medicine and the Russian Academy of Medical Science (2011) / Chapter Skim
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3 Drug-Resistant Tuberculosis in the Russian Federation
3 Drug-Resistant Tuberculosis in the Russian Federation
Pages 29-36
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From page 29... ...
Russia is a vast country, and the incidence of TB differs as much as tenfold among 1 Thisintroductory text and the following section are based on the presentation of Mikhail Perelman, Moscow Medical Academy. 2 In Russia, estimated TB incidence (new and relapse cases)
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From page 30... ...
In addition, surgery is complex and expensive and requires specialized departments and personnel who are aware of the TB problem.3 The proper approach to TB in Russia today, said Perelman, is for every person suspected of having TB to undergo a general medical checkup, including a chest examination. Russia did not accept DOTS 3 In Russia, surgery is considered a component of treating patients with chronic TB that has been unresponsive to antimicrobial therapy, as well as newly diagnosed TB patients with complications, drug resistance, and/or intolerance to anti-TB drugs (Perelman, 2000)
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From page 31... ...
Perelman believes that patients left the program undertreated, and this short course was one of the reasons for the broad spread of MDR TB. Perelman stated that MDR TB also can result if treatment is discontinued based on sputum tests without consideration of cavities in lungs.
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From page 32... ...
Detection and treatment also have low ered the percentages of people with TB in Russia who suffer the destructive pulmonary form of the disease. 214.7 Men 200.00 190.4 Women Men, not incarcerated 170.3 Women, not incarcerated Incidence per 100,000 Population 160.7 150.00 156.4 158.5 93.1 100.00 50.00 0.00 0–14 15–24 25–34 35–44 45–54 55–64 65> Age FIGURE 3-1 TB incidence by gender and age rises to a peak between ages 25 and Figure 3-1.eps 34.
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From page 33... ...
An emphasis on TB in national and regional health programs has contributed to this decrease, with a new TB early detection and prevention program starting in 2010. Preventive measures, including infection control and vaccination or prophylactic chemotherapy, must be clearly designed and organized, Yakimova stated.
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From page 34... ...
An assessment of MDR TB data that began last year has made it possible to calculate the primary incidence and prevalence of pulmonary MDR TB. Review of these data in turn makes it possible to evaluate the success rates for MDR TB treatment.
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From page 35... ...
percent of culture-positive patients should be investigated. Also, with effective TB prevention, widespread drug susceptibility testing, and widespread treatment, the incidence of pulmonary MDR TB should not exceed 1.5 per 100,000 population, and prevalence should not exceed 9 per 100,000.
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From page 36... ...
As this capacity is increased, incidence rates will increase as well. And with an overall incidence of MDR TB of 4 per 100,000 population, the rate of new cases remains significantly higher than the national goal of 1.5 per 100,000 population.
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