S.A. Sterlikov
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Abstract. Low efficacy of treatment of tuberculosis patients in the Russian Federation prevents the rapid decline in tuberculosis incidence rates. To find ways for improving treatment efficacy it is necessary to examine organizational problems that lead to low efficacy and identify ways for improvement.

The aim of the study is to assess dynamics in TB treatment outcomes and reasons for low efficacy based on the use of new international definitions and to identify regions with best organizational models for TB treatment.

Materials and data. Analysis of TB Form #8 “Data on outcomes of courses of chemotherapy for pulmonary TB” for 2010-2013. Standard methods of statistical data processing were used.

Results. Efficacy of treatment of both all new pulmonary tuberculosis cases and the cohort of smear-positive cases with preserved sensitivity to isoniazid and rifampicin in 2010-2013 remained almost unchanged. In 2013 the treatment efficacy added up to 72.0 and 64.2% respectively. Percent of treatment failures remained stable (7.8 and 10.8% respectively). Decreased share of patients with chemotherapy default is balanced by increased share of transferred patients. The structure of mortality is marked by an increasing share of patients who died not from tuberculosis. Best organizational practices implemented in the regions of the Russian Federation can be effective (79.2%) to treat new smear-positive cases.

Conclusion. During the past four years no significant progress was made in control over chemotherapy and laboratory diagnosis of tuberculosis. Increased share of patients who died not from tuberculosis, can lead to the situation when decrease in mortality due to improved measures aimed at early TB detection cannot offset the increase in mortality of those patients from other causes. 16 regions that can serve as the organizational model for TB treatment were identified.

Keywords: tuberculosis; efficacy of sanatorium treatment; efficacy of collapsotherapy; efficacy of chemotherapy of tuberculosis; new definitions and tuberculosis reporting; organization of treatment of TB patients.

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