PRIMARY MULTIDRUG RESISTANCE OF TUBERCULOSIS MYCOBACTERIUM ACCORDING TO DATA OF KRASNOYARSK REGIONAL TUBERCULOSIS DISPENSARY № 1 IN-PATIENT DEPARTMENT

This study of multidrug resistance (MDR) of tuberculosis mycobacterium. (TMB) frequency has revealed, that in 2011 28,4 % persons discharging bacteria with, newly diagnosed pulmonary tuberculosis had multidrug resistance of tuberculosis mycobacterium and among them are (70,1 %), rural population. (57,7 %), non-workers of employable age (56,7 %) prevailed. Among patients with, multidrug resistance (MDR) of tuberculosis mycobacterium. (TMB) there was a great propotion of patients with, disseminated tuberculosis (39,2 %), infiltrative tuberculosis (44,3 %), caseous pneumonia (7,2 %); there were 55,6 % of cases with profuse bacterioexcretin due to the violation of the Chest X-ray examination, terms. 45,3 % of patients with multidrug resistance also had. resistance to other essential antituberculosis drugs; in 54,7 % cases besides combination of this resistance there was also the rescue therapy drug resistance. Medical comment was made that under modern conditions it is not advisable to use chemotherapy of the first mode with patients with newly diagnosed pulmonary tuberculosis

TIMELY DETECTION OF PULMONARY TUBERCULOSIS AND INFLUENCING FACTORS

This study presents analysis of the timely detection of pulmonary tuberculosis in 1334 patients who underwent treatment in the Regional TB Dispensary N1 in Krasnoyarsk city in 2010-2011. Late detection of tuberculosis was established in 60,2 %, and factors which are contributing to it were as following: the male, living in rural areas, social vulnerability, and. violation of the regulated terms of X-ray examination. The significance of late diagnosed patients to increase the reservoir of tuberculosis infection and spread of drug-resistant strains among the population was shown. It was determined that an increase in coverage of population by preventive X-ray examinations resulted in improvement of quality indicators only in 2,6 % of active detection of pulmonary tuberculosis in the form of growing proportion of the patients revealed during preventive examinations timely, as well as reducing proportion of fibro-cavernous pulmonary tuberculosis and. post-mortem diagnosis of tuberculosis among the newly diagnosed patients. During the active detection of TB among population with a focus of work on real, established during the research, its groups the conclusion about the need to use the obtained results was made

EPIDEMIOLOGICAL ASPECTS OF THE TUBERCULOSIS PATHOMORPHISM IN MODERN CONDITIONS

Not only the growth of the death, rate and the morbidity rate can be considered as epidemiological manifestation. of the tuberculosis pathomorfism in modern conditions but also the changes of biological properties of the activator. Since 2003 till 2011 mycobacterium drug resistance with the patients with the newly diagnosed infiltrative tuberculosis which is of the most frequent occurrence has increased 1,4 times. The mycobacterium drug resistance has undergone the apparent qualitative changes. The percent of multidrug resistance has also increased. The combination of multidrug resistance and rescue therapy drug resistance has become more often. At the same time bacterioexcretin has become more profuse, mycobacterium growth rate has become slower and. the fact proves there is an interaction between two their biological properties - drug resistance and. growing power

Segmentation of microscopic images of sputum stained by Ziehl - Nielsen using wavelet transform Mexican Hat

Background. Currently at bacterioscopic diagnosis of tuberculosis there is a large number of errors that is associated with a number of problems that can be solved by automated analysis of microscopic images of sputum. Automated image analysis usually consists of several stages: image segmentation and identification or recognition of objects in the image. The article examines the first of these stages - segmentation. The aim of the study was to investigate the possibility of segmenting a digital image of a microscopic preparation sputum, stained by the method of Ziehl - Nielsen, using wavelet transform Mexican Hat. Materials and methods. As research material we used 830 digital images obtained by microscopy of sputum smears stained by the method of Ziehl - Nielsen. For the automated segmentation of images we used two-dimensional wavelet transform of Mexican Hat Wavelet. Results. During the study we defined the optimal value of the a parameter, which is the only varying parameter of a wavelet Mexican Hat, and carried out the run-time evaluation of the wavelet transform digital microscopic images of sputum stained by the method of Ziehl - Nielsen. Conclusions. The conclusion is made about possibility of using two-dimensional wavelet transform Mexican Hat digital microscopic images of sputum stained by the method of Ziehl - Nielsen, for segmentation of these images

Туберкулез и табакокурение: риск развития специфического процесса и его особенности у курящих больных

The purpose of the study was to investigate effects of smoking on risk of pulmonary tuberculosis and clinical course of newly diagnosed tuberculosis. Methods. We questioned 342 patients with newly diagnosed pulmonary tuberculosis (of them, 296 active smokers; 86.5%) and 386 healthy individuals (115 smokers; 29.8%). To analyze an effect of smoking on occurrence of pulmonary tuberculosis, the odds ratio (OR), absolute and attributive risks and potential hazard index (number of subjects who should be exposed to a hazardous factor for development one case of a disease) were calculated. Results. Tobacco smoking was associated with 15-fold increase in the risk of tuberculosis (OR 15.16; 95%CI: 10.37; 22.16). This risk was directly related to number of cigarettes smoked per day and to smoking duration. The potential hazard index was less related to number of cigarettes smoked per day (3.87) or smoking duration (4.87) and more closely related to the smoking itself (1.74). Clinical course of pulmonary tuberculosis was analyzed in 296 active smokers with newly diagnosed disease. Conclusion. More severe course of newly diagnosed pulmonary tuberculosis was related to starting tobacco smoking at earlier age, smoking duration, and greater number of cigarettes smoked per day. Furthermore, heavier smoking was associated with more extending lung injury. Tobacco smoking was related to probability of development of pulmonary tuberculosis and to severity of the disease. There is a need of smoking control both in healthy population and in patients with tuberculosis.Высокий уровень распространенности табакокурения в Российской Федерации (постоянно курят 39,1 % взрослого населения) и высокий показатель заболеваемости туберкулезом обуславливают актуальность изучения влияния табакокурения на развитие туберкулеза легких (ТЛ). Цель. Изучение влияния табакокурения, его интенсивности и длительности на риск развития ТЛ, а также на структуру клинических форм и характеристику впервые выявленного специфического процесса. Материалы и методы. Были проинтервьюированы впервые выявленные больные ТЛ (n = 342), из них курили 296 (86,5 %), и 386 здоровых лиц (курящих 115 (29,8 %)). Для анализа влияния табакокурения на развитие ТЛ рассчитывались коэффициент отношения шансов (ОШ), показатели абсолютного и атрибутивного риска развития ТЛ, а также индекс потенциального вреда. Результаты. Установлено, что при табакокурении увеличивается риск развития специфического процесса более чем в 15 раз (ОШ – 15,16 (10,37; 22,16)), а степень риска находится в прямой зависимости от количества выкуриваемых в день сигарет и длительности стажа курения. Показано, что индекс потенциального вреда определяется не столько количеством выкуриваемых сигарет и длительностью стажа курения, сколько самим его фактом (3,87; 4,87 и 1,74 соответственно). Для определения влияния табакокурения на структуру клинических форм и характеристику процесса проанализированы данные о 296 курящих впервые выявленных больных ТЛ. Заключение. Констатировано, что начало табакокурения в более раннем возрасте, длительность его стажа, большее количество выкуриваемых сигарет, а соответственно, более высокий индекс курильщика (ИК) утяжеляют структуру клинических форм впервые выявленного туберкулеза. Кроме того, увеличение стажа курения и ИК способствуют развитию распространенных процессов в легких. Доказано отрицательное воздействие табакокурения на вероятность развития ТЛ, которое в случае возникновения специфического процесса утяжеляет его характер. Сделано заключение о необходимости проведения борьбы с этой вредной привычкой, как среди здорового населения, так и среди больных туберкулезом

Влияние возраста, пола и социальных факторов на риск выявления туберкулеза легких

Summary. A contribution of age, gender and social factors to probability of pulmonary tuberculosis occurrence in various cohorts of population was analyzed. On the basis of the obtained data, a computer system was developed to define a total individual risk of pulmonary tuberculosis occurrence. This approach could allow estimation of rate of preventive fluorographic investigation in different population cohorts.Резюме. Была проанализирована значимость возраста, пола, социальных факторов на вероятность выявления туберкулеза легких у различных категорий населения. Полученные данные включены в разрабатываемую компьютерную систему, определяющую суммарный индивидуальный риск выявления туберкулеза легких, что позволит научно обосновать кратность прохождения проверочного флюорографического обследования различными категориями населения

Newly diagnosed respiratory organs tuberculosis with organized and unorganized population

The study purpose: comparative analysis of clinical cases structure, and to characterize the process with organized and unorganized population. The data under consideration concern newly diagnosed respiratory organs tuberculosis with in-patients at the age of 18 and older which were treated at the Krasnoyarsk Territory ТВ dispensary №1 in the years of 2007-2009.660 patients belonged to organized population and 1403 patients belonged to unorganized population. More severe structure of clinical cases and process characteristics with patients among unorganized population were determined. That was due to the fact that among them there were a great proportion of persons violating decreed terms of having their lungs X-rayed. Medical comment was made for managers of medical and preventive treatment institutions referring to public medical network. They should pay more attention to exercising control over maintenance of frequent X-ray lungs examination and following up not only patients from organized population who have been examined. But they also must take into account patients who have not been examined. And special attention must be paid to those from unorganized population because an epidemic danger which they constitute is two times greater than an epidemic danger which is constituted by organized population. Data resulting from the study may be used while planning of tuberculosis detection among different population categories.Цель работы: сравнительный анализ структуры клинических форм, характеристики процесса у организованного и неорганизованного населения. В разработку взяты данные о всех впервые выявленных больных туберкулезом легких в возрасте 18 лет и старше, проходивших стационарное лечение в Красноярском краевом противотуберкулезном диспансере №1 в 2007-2009 гг.: 660 больных - организованное население, 1403 - неорганизованное. Установлена более тяжелая структура клинических форм, характеристика процесса у заболевших из числа неорганизованного населения, что в значительной мере связано с доказанным большим удельным весом среди них лиц, нарушающих декретированные сроки флюорообследования (ПФЛГО). Сделано заключение о необходимости усиления контроля со стороны руководителей лечебно-профилактических учреждений общей лечебной сети за соблюдением регулярности прохождения ПФЛГО путем учета не только прошедших обследование, но и не прошедших его, особенно лицами из состава неорганизованного населения. Последнее приобретает особую важность ввиду их почти в 2 раза более высокой эпидемиологической опасности в случае развития заболевания. Полученные данные могут быть использованы при планировании и организации активного выявления туберкулеза среди различных категорий населения

Анализ влияния социально-бытовых факторов на риск развития туберкулеза легких

The aim of this study was to identify social risk factors of pulmonary tuberculosis.Methods. We used a questionnaire to evaluate living conditions, number of subjects living together, including children; dwelling space, and family income.Results. The study involved 342 patients with newly diagnosed pulmonary tuberculosis (56.4±5.26% were men) and 386 healthy individuals (54.7±4.97% were women). Poor living conditions (OR = 8.4 (5.25; 13.44); p < 0.001) and extremely low income (OR = 2.5 (2.17; 2.97); p < 0.001) were associated with the highest risk for pulmonary tuberculosis morbidity followed by living in an individual household, small dwelling space, low family income and less living rooms in a house. A relatively small proportion of TB foci involving children was found.Conclusion. The results can facilitate targeted measures for active diagnosis of pulmonary tuberculosis in high risk cohorts. This could increase efficacy of preventive measures and reduce diagnostic costs per a patient.Цель. Анализ влияния факторов, связанных с социально-бытовыми условиями, на риск развития туберкулеза легких (ТЛ) с учетом места проживания, благоустройства жилья, числа комнат, числа совместно проживающих лиц, в т. ч. детей, общей площади и площади на 1 проживающего, а также общесемейного дохода и дохода на 1 члена семьи.Материалы и методы. Исследование проводилось на основе данных интервьюирования впервые выявленных больных ТЛ (n = 342) (1я группа) и здоровых лиц (n = 386) (2я группа). В 1й группе преобладали мужчины (56,4 ± 5,26 %), а во 2й – женщины (54,7 ± 4,97 %).Результаты и обсуждение. Установлено, что риск развития ТЛ в наибольшей степени повышается при воздействии таких факторов, как неблагоустроенные условия проживания (отношение шансов (ОШ) – 8,4 (5,25; 13,44); p < 0,001) и доход ниже прожиточного минимума (ОШ – 2,5 (2,17; 2,97); p < 0,001). Факторы риска распределились по мере уменьшения значимости: проживание в отдельных домохозяйствах, недостаточная жилая площадь на 1 члена семьи, низкий уровень общесемейного дохода и малое число комнат. Констатирован относительно благоприятный фактор – наличие очагов туберкулезной инфекции ввиду малого удельного веса очагов с проживающими в них детьми.Заключение. С помощью полученных данных появилась возможность проводить целевые мероприятия по активному выявлению ТЛ среди лиц с повышенным риском развития этого заболевания, что, несомненно, способствует существенному повышению их эффективности и выявляемости на 1 000 обследованных и, соответственно, снижению стоимости выявления 1 больног

CLINICAL AND SOCIAL CHARACTERISTICS OF PENAL INSTITUTIONS INMATES WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS

The spread of tuberculosis in the penitentiary system institutions has a significant impact on the epidemic situation in the country. The aim of the research is to study the clinical and social characteristics of newly diagnosed patients with pulmonary tuberculosis among the special contingent prisons. Analyzed data include 107 cases of pulmonary tuberculosis newly diagnosed in 2014 among inmates of penitentiary institutions. We studied the age structure of the patients, their educational level, number of previous convictions, family status, addictions and comorbidity, ways of revealing pulmonary tuberculosis, the structure of its clinical forms and characteristics of the specific process. It is established that in the conditions of penitentiary system tuberculosis often affects repeatedly convicted persons with low education level; and in most cases, the disease develops in the first two years of imprisonment. Low level of health literacy of patients, along with the lack of family in more than 2/3 of cases, reduces the motivation and commitment to treatment. We concluded that there is a need for sanitary-educational work of two directions among persons in penal institutions. First, healthy individuals should be filled in on clinical symptoms of pulmonary tuberculosis and with a focus on the need to seek medical help immediately after its occurrence. Second, to reduce the refused treatment rate, the continuous and purposeful work must be done to form commitment to therapy

Construction of Polymeric Antigenic Diagnosticum Based on <i>Vibrio cholera</i> О1 Lipopolysaccharide

Representatives of the genus Vibrio cholerae differ in the structure of lipopolysaccharide, in particular, its O-polysaccharide chains (O-antigen), which determines the serological specificity of vibrios. Currently, the water-phenolic method is used to obtain the lipopolysaccharide preparation. However, this technique relates to harsh chemical methods, leads to a change in original molecular organization of biopolymer, violating its structure and biological properties. Modern technologies in the development of diagnostic kits for the immunosuspension reaction of volume agglomeration allow for obtaining synthetic carriers with different reaction groups on the particle surface capable to bind antigens/antibodies. The aim of this study was to construct cholera antigenic polymeric diagnostic kit based on the lipopolysaccharide of Vibrio cholerae O1 serogroup. Materials and methods. The lipopolysaccharide was used as a sensitizer obtained through the author's modification of enzymatic purification from the cell membranes of Vibrio cholerae using ultrasonic disintegration. Results and discussion. The resulting sensitin contains small impurities of protein (1.5 %) and nucleic acids (0.1 %). Diagnosticum is characterized by high analytical sensitivity in agglomeration reaction with commercial and experimental rabbit serum to Vibrio cholerae O1 serogroup (1:640 - 1:5120) and analytical specificity (the diagnosticum does not interact with heterologous sera, with serums to pathogens of acute intestinal infections, as well as with sera from healthy donors). A polymeric antigenic cholera diagnosticum designed to detect antibodies to lipopolysaccharide of Vibrio cholerae in the blood serum of patients who were ill, suspected of the disease or vaccinated people has been constructed