Dynamics of the incidence of the relapses in patients with pulmonary tuberculosis

V. Melnyk, V. Matusevych, O. Nedospasova, L. Veselovsky, O. Tarasenko, I. Bushura, A.M. Prychodko, I. Novozhylova
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Abstract

BACKGROUND. Among countries of Europe in Ukraine the incidence and mortality rate from tuberculosis (TB), including the incidence of the relapses in patients with pulmonary tuberculosis (RPT), remain high. Absence of the national program of fight from TB, lack of financing of anti-TB measures, unsatisfactory statistical information confirm the necessity of study of situation from relapses in patients with RPT and development of measures on their warning. OBJECTIVE. To estimate the features of dynamics of the incidence of RPT in the last few years and consisting of epidemic situation of TB in a country. MATERIALS AND METHODS. An analysis of official statistical reports of anti-TB establishments of administrative territories of Ukraine, information of SI “Center of Public Health of the Ministry of Health of Ukraine” and SI “Center of Medical Statistics of the Ministry of Health of Ukraine” in the last few years. RESULTS AND DISCUSSION. By the features of dynamics of the incidence of RPT in the last few years in a country are high the incidence in patients with RPT with sputum positive smears with comparison in the incidence in patients with RPT with sputum negative smears; decline of index on 46,0 %; high part of RPT with sputum positive smears among patients with TB sputum positive smears (the TB new cases + relapses); diminishing of amount of cases of TB which the diagnosis of multidrug-resistant TB is confirmed, from them growth of percent of patients with extended resistant of Mycobacterium tuberculosis. The signs of epidemic situation are: decline of the TB incidence of lights (the new cases + relapses); high percent of patients sputum positive smears; high TB incidence among children by age 15-17; diminishing of the TB mortality rate and his prevalence; absence of changes of index prevalence of TB among children by age 0-17 and 0-14. CONCLUSIONS. The analysis of statistical data testifies to the presence of failings in an exposure and treatment of patients with the relapses of TB, on the necessity of introduction of complex anti-TB measures for warning of relapses within the framework of the national program of fight from TB.
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肺结核患者复发率的动态变化
背景。在乌克兰的欧洲国家中,结核病的发病率和死亡率,包括肺结核患者的复发率仍然很高。国家防治结核病规划的缺乏、抗结核措施资金的缺乏、统计信息的不满意,证实了对RPT患者复发情况进行研究和制定预防措施的必要性。目标。估计一个国家近年来结核病发病率的动态特征,包括结核病的流行情况。材料和方法。对乌克兰行政区域内抗结核机构的官方统计报告、“乌克兰卫生部公共卫生中心”和“乌克兰卫生部医学统计中心”过去几年的信息进行分析。结果和讨论。根据一个国家近年来RPT发病率的动态特点,痰涂片阳性的RPT患者发病率较高,痰涂片阴性的RPT患者发病率较低;指数下跌46.0%;结核痰涂片阳性患者中痰涂片阳性RPT比例高(结核新发病例+复发病例);确诊为耐多药结核病的结核病病例数量减少,其中结核分枝杆菌长期耐药患者的百分比有所增加。疫情的迹象是:结核病发病率下降(新发病例+复发);痰涂片阳性患者比例高;15-17岁儿童结核病发病率高;降低结核病死亡率和患病率;0-17岁和0-14岁儿童结核病患病率指数未见变化。结论。对统计数据的分析证明,在结核病复发患者的暴露和治疗方面存在缺陷,并证明有必要在国家防治结核病规划的框架内采取复杂的抗结核病措施,以警告结核病复发。
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