NEW METHOD OF EPIDEMIOLOGICAL EVALUATION OF THE INCIDENCE OF COMPLICATIONS AFTER ANTI-TUBERCULOSIS VACCINATION

The article offers a new method for calculation of incidence of complications after primary anti-tuberculosis vaccination. Using the example of analysis of continuous sampling of complications after anti-tuberculosis vaccination (n = 110) in Irkutsk Region in 2005-2014 the article shows the advantage of the offered method compared to the existing ones

The prion dilemma confounding science educators

In this paper, the issue of the prion hypothesis, a simmering controversy within the scientific community, is addressed. We inquire into the appropriateness of the use of certain augmentations and rhetoric approaches used during scientific debates, as well as the aptness of unequivocal statements in textbooks that indicate “abnormal prions” as a primary cause of Transmissible Spongiform Encephalopathies

Complications of BCG vaccination: modification of the statistical procedure

There is no uniform method to conduct the epidemiological monitoring of BCG complications in the Russian Federation, Current indicators of BCG complications include the number of complication cases (cases registered within two years after vaccination) and the total number of the vaccinated children. Our aim is to discover a new indicator of BCG complications and to compare it with the indicators of the existing methods, The comparative analysis of new and existing methods of all complication cases (continuous sampling, n = 110) was conducted in the Irkutsk Region (Eastern Siberia) from 2005 to 2014, The calculating formula included the ratio of the number of children with complications vaccinated in the analyzed year to 100,000 children vaccinated in the same year, The new method shows the advantages over the existing methodological approaches, It demonstrates more adequate assessment, expressed in the highest approximation coefficient of trend model compared to the other methods, and stability of indicator over the years, The incidence of complications in the Irkutsk Region has a steady decreasing linear trend and a significant negative growth rate of the indicator (-17,9 %), The new method offers an adequate assessment and can be used as an epidemiological control system not only in the Russian Federation but in other high TB-burden countries with massive BCG vaccination of children

ОПЫТ РАННЕЙ ЩАДЯЩЕЙ ИММУНИЗАЦИИ ВАКЦИНОЙ БЦЖ-М ДЕТЕЙ С ПЕРИНАТАЛЬНЫМ КОНТАКТОМ ПО ВИЧ

A practice of an early reduced-antigenic-load BCG-M vaccination of HIV-exposed infants inIrkutskdistrict, a district with the high HIV and tuberculosis (TB) prevalence, had been evaluated. It had been establish that the vaccination within the conventional time frame leads to the development of an anti-tuberculous immune response which, usually, is verified by the post-immunization reactions and the tuberculosis skin test results. A high safety of the reduced-antigenic-load BCG-M vaccination had been confirmed in cases with perinatally HIV-infected infants. The clinical development of the TB infection in non-vaccinated children, especially of the youngest age, had been characterized by a development of the hazardous complications which tend to be persistent. С позиций эффективности и безопасности оценен опыт ранней щадящей иммунизации вакциной БЦЖ-М детей с перинатальным контактом по ВИЧ на территории Иркутской области — регионе с высокой превалентностью и инцидентностью ВИЧ-инфекции и туберкулеза. Ранняя щадящая иммунизация на основе традиционных сроков проведения и показаний к вакцинации формирует адекватный, умеренно выраженный противотуберкулезный иммунитет, подтверждаемый местными постпрививочными реакциями и кожными туберкулиновыми тестами. Подтверждена высокая безопасность ранней щадящей вакцинации БЦЖ у детей при реализации перинатальной ВИЧ-инфекции. Клиническое течение туберкулеза у не вакцинированных детей, особенно раннего возраста, отличается тяжелым осложненным течением, склонным к прогрессированию.

Критерии интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза

The objective of the study: to establish criteria for the integration of epidemic processes of HIV infection and tuberculosis. Subjects and methods. The article presents the retrospective analysis of the long-term changes in the main epidemiological rates of HIV-infection and tuberculosis in two regions within the Siberian Federal District, and these rates were compared with data for the whole of Russia. Results. The following criteria for the integration of epidemic processes of HIV infection and tuberculosis were established: simultaneous development of epidemic processes; high activity of epidemic processes with involvement of the general population (HIV prevalence of more than 6500/0000, tuberculosis incidence of more than 1200/0000); positive statistically significant correlations at least in pairs of indicators, which were HIV prevalence – incidence of tuberculosis and HIV prevalence - incidence of tuberculosis in the HIV positive population. The conclusion about the integrative effect of HIV infection on the spread of tuberculosis should be made using all three criteria.Цель исследования: установление критериев интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза. Материалы и методы. Проведен ретроспективный анализ многолетней динамики и взаимосвязи основных эпидемиологических показателей по ВИЧ-инфекции и туберкулезу на двух территориях Сибирского федерального округа в сопоставлении с общероссийскими данными. Результаты исследования. Установлены следующие критерии интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза: одновременное развитие эпидемических процессов; высокая активность эпидемических процессов с вовлеченностью общей популяции населения (пораженность ВИЧ-инфекцией более 6500/0000, заболеваемость туберкулезом более 1200/0000); положительные статистически значимые корреляционные связи как минимум в парах показателей «пораженность ВИЧ-инфекцией – заболеваемость туберкулезом» и «пораженность ВИЧ-инфекцией – заболеваемость туберкулезом пораженного ВИЧ-инфекцией населения». Заключение о наличии интеграционного влияния ВИЧ-инфекции на распространение туберкулеза должно быть сделано при соблюдении всех трех критериев

Features of Epidemic Process of Tuberculosis in the Territory with High Prevalence of HIV Infection

Scales of epidemic process of HIV-associated of tuberculosis are especially noticeable in regions with high prevalence of HIV infection and tuberculosis. A striking example of this situation is the Irkutsk region – the territory with the highest prevalence of HIV infection in the Russian Federation and one of the most unsuccessful one on tuberculosis – in 2010 became Russian “leader” and in prevalence of the HIV-associated tuberculosis, keeping a position “in the first five” so far. It is clear, that all this cannot but imply negative manifestations of two considered epidemic processes at their simultaneous development in one territory. The above-said facts predetermined carrying out the retrospective epidemiological analysis of spread of tuberculosis among the cumulative population in the Irkutsk region, a territory of high risk of HIV infection.The purpose of the work was to assess features of spread of tuberculosis in the territory of the large center of HIV infection (Irkutsk region).Results. The expressed negative impact of HIV infection on epidemic process of tuberculosis in the studied region, shown in divergence of trends and higher levels of epidemiological indicators in comparison to the all-Russian data is established.Conclusion. As a result of a research the trend of regional incidence of tuberculosis, multidirectional with the all-Russian indicators, is established from the moment of epidemic spread of HIV infection that demonstrates integration of epidemic processes of the studied infections. Even on condition of regress of epidemic process of tuberculosis at the end of the analyzed period which is followed by decrease in incidence of all population, HIV infection has a significant impact on his tension that, certainly, demands the strengthened measures of epidemiological control of these socially important infections

Критерии интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза

The objective of the study: to establish criteria for the integration of epidemic processes of HIV infection and tuberculosis. Subjects and methods. The article presents the retrospective analysis of the long-term changes in the main epidemiological rates of HIV-infection and tuberculosis in two regions within the Siberian Federal District, and these rates were compared with data for the whole of Russia. Results. The following criteria for the integration of epidemic processes of HIV infection and tuberculosis were established: simultaneous development of epidemic processes; high activity of epidemic processes with involvement of the general population (HIV prevalence of more than 6500/0000, tuberculosis incidence of more than 1200/0000); positive statistically significant correlations at least in pairs of indicators, which were HIV prevalence – incidence of tuberculosis and HIV prevalence - incidence of tuberculosis in the HIV positive population. The conclusion about the integrative effect of HIV infection on the spread of tuberculosis should be made using all three criteria.Цель исследования: установление критериев интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза. Материалы и методы. Проведен ретроспективный анализ многолетней динамики и взаимосвязи основных эпидемиологических показателей по ВИЧ-инфекции и туберкулезу на двух территориях Сибирского федерального округа в сопоставлении с общероссийскими данными. Результаты исследования. Установлены следующие критерии интеграции эпидемических процессов ВИЧ-инфекции и туберкулеза: одновременное развитие эпидемических процессов; высокая активность эпидемических процессов с вовлеченностью общей популяции населения (пораженность ВИЧ-инфекцией более 6500/0000, заболеваемость туберкулезом более 1200/0000); положительные статистически значимые корреляционные связи как минимум в парах показателей «пораженность ВИЧ-инфекцией – заболеваемость туберкулезом» и «пораженность ВИЧ-инфекцией – заболеваемость туберкулезом пораженного ВИЧ-инфекцией населения». Заключение о наличии интеграционного влияния ВИЧ-инфекции на распространение туберкулеза должно быть сделано при соблюдении всех трех критериев

Viability of causative pathogen in patients with drug-sensitive and drug-resistant forms of respiratory tuberculosis

To predict outcomes of tuberculosis we investigated the viability of Mycobacterium tuberculosis (MTB) in relation to drug resistance of strains and clinical manifestations of tuberculosis. During the study on solid Löwenstein - Jensen medium, we determined the speed, growth rate and drug resistance of MBT in 5945 cultures, isolated from the sputum of patients with pulmonary tuberculosis - residents of the Irkutsk region (2193 -from newly diagnosed patients, 3752 - from previously treated patients). The criterion of high viability of MBT was the growth rate of >100 colonies over 20 days; and low viability corresponded with the growth rate of 30 days. 2171 cultures (36.5 %) had high viability of MBT strains, 3021 (50.8 %) - low, and 753 (12.7 %) cultures had average degree of viability. A high degree of pathogen viability was more often determined in newly diagnosed patients with tuberculosis of intrathoracic lymph nodes (all patients with HIV-infection without antiretroviral therapy), fibrotic-cavernous and infiltrative tuberculosis. Among previously treated patients with tuberculosis the high viability of MBT was often determined in patients with fibrous-cavernous and infiltrative tuberculosis, and caseous pneumonia. Cultures from previously treated patients with tuberculosis of intrathoracic lymph nodes had low degree of viability. The number of drug-sensitive strains was 1992, drug-resistant ones - 3953, including 1430 strains with multidrug resistance. We have found that 37.5 % drug-resistant strains associated with a high degree of viability (multidrug resistance - 38.5 %), it's was more often than the drug-sensitive (35.4 %; p < 0.01)