O.B. Netchayeva, Ye.Yi. Skatchkova, O.K. Biragova
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
Summary. Background: The Federal Program:
Prevention and combatting socially sensitive conditions in 2007-11,
subprogram: tuberculosis -had put forward the endpoints (by 2011) of
TB-bacillus-free proportion in the pool of TB patients as 41.6% and of
TB-caused mortality as 17.8 cases upon 100.000 of the population. Now
these two endpoints have been surpassed reaching 35.9% and 14.2 cases,
accordingly. There exists an opinion, however, that these endpoints of
the subprogram had been down-graded from the very beginning simply on
the premise that in reality they were reached in 1-2 years after the
launch of this Program.
Results of the study: The analysis of real situation with tuberculosis in Russia showed that:
-
The ratio of TB incidence produced by legally free population to that
of the cohort of prisoners and convicts has become quite stable at the
level fixed in 2011 as 83.8%: 11.3%
-
Many epidemiologic features in the cohort of prisoners and convicts factually mimicked the situation in legally free population
-
More advanced rates of reducing TB-caused mortality than in reducing
incidence rates were identified as potentially favorable tendency.
Incidence: mortality ratio has raised in 2005-11 from 3.7 to 5.7 in the
overall population; from 3.2 to 4.4 in males, from 6.2 to 8.1 in
females; from 3.8 to 5.3 in the urban and from 3.5 to 4.9 in the rural
population.
Conclusion: epidemic situation in Russia has moved towards
certain stabilization, the counter-factors still persisting, were: 1.
advancements in HIV-infection in Russia, as the situation with
HIV-infection obviously tends to contribute more and more to the
incidence and prevalence of tuberculosis; 2. epidemiologic growth of
multiple drugs resistance (MDR) of TB mycobacteria to anti-TB
preparations. MRN in TB could readily infringe on the treatment
efficiency and thus could prospectively lead to increased mortality.
Keywords. Federal task-wise program; endpoints of public health; quality grade of healthcare; tuberculosis; HIV-infection.
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