Pub Date : 2024-03-19DOI: 10.58838/2075-1230-2024-102-1-20-25
R. M. Timofeev, A. N. Marchenko, N. D. Pirogova, A. A. Kalashnikov
The objective: to analyze tuberculosis incidence and assess prevalence of latent tuberculosis infection (LTBI) among employees of Forensic Medicine Bureau (FMB) in Tyumen Region.Subjects and Methods. Tuberculosis incidence was retrospectively studied, and employees of Forensic Medicine Bureau in Tyumen Region were examined in order to detect latent tuberculosis infection.Results. In 2003-2022, the long-time average annual incidence made 105.4±23.6 per 10,000 workers. The number of employees who had suffered tuberculosis with up to 5 years of experience in the bureau was greater versus employees with 6-10 years of experience and 11-15 years of experience. The level of LTBI based on the TRA test results was 32.7±4.5%. Tuberculosis incidence and the rate of LTBI among employees performing autopsies were higher versus employees of other departments of Forensic Medicine Bureau.
{"title":"Analysis of Tuberculosis Incidence among Employees of Forensic Medicine Bureau in Tyumen Region in 2003-2022","authors":"R. M. Timofeev, A. N. Marchenko, N. D. Pirogova, A. A. Kalashnikov","doi":"10.58838/2075-1230-2024-102-1-20-25","DOIUrl":"https://doi.org/10.58838/2075-1230-2024-102-1-20-25","url":null,"abstract":"The objective: to analyze tuberculosis incidence and assess prevalence of latent tuberculosis infection (LTBI) among employees of Forensic Medicine Bureau (FMB) in Tyumen Region.Subjects and Methods. Tuberculosis incidence was retrospectively studied, and employees of Forensic Medicine Bureau in Tyumen Region were examined in order to detect latent tuberculosis infection.Results. In 2003-2022, the long-time average annual incidence made 105.4±23.6 per 10,000 workers. The number of employees who had suffered tuberculosis with up to 5 years of experience in the bureau was greater versus employees with 6-10 years of experience and 11-15 years of experience. The level of LTBI based on the TRA test results was 32.7±4.5%. Tuberculosis incidence and the rate of LTBI among employees performing autopsies were higher versus employees of other departments of Forensic Medicine Bureau.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140230126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-13-19
L. N. Savonenkova, D. Kolchin, V. Ruzov, N. A. Slobodnyuk, O. Y. Prokhorov, S. V. Anisimova
The objective: to determine the significance of chronic cor pulmonale (CCP) as a cause of death in pulmonary tuberculosis patients.Subjects and Methods. Out of 194 autopsies of tuberculosis patients who died in Hospital no. 1 of Ulyanovsk Regional Clinical TB Dispensary in 2017-2020, autopsy reports of 87 patients with pathomorphological signs of chronic cor pulmonale were selected. The nature and prevalence of pathomorphological manifestations of tuberculosis and the causes of deaths were analyzed. Statistical analysis of the results was performed using the STATISTICA-10. The significance of differences in the frequency of events was determined using the χ2 criterion in a four-field 2х2 table.Results. Chronic cor pulmonale was confirmed pathomorphologically in 44.8% of deceased pulmonary tuberculosis patients. Chronic cor pulmonale was diagnosed in 67.8% of patients in their lifetime, and in 32.2%, it was diagnosed post mortem. Of 87 deceased patients with pulmonary tuberculosis complicated by chronic cor pulmonale, 28.7% had fibrous cavernous pulmonary tuberculosis, 26.4% had infiltrative form and 44.9% had disseminated form of the disease. Decompensated chronic cor pulmonale leading to death was detected in 42.5% of the deceased, and it was predominant in the structure of causes of death in fibrous cavernous tuberculosis (84%), and this pathology was also found in the patients with infiltrative (52.5%) and disseminated (10.3%) pulmonary tuberculosis.
{"title":"Chronic Cor Pulmonale in the Structure of Fatal Outcomes of Pulmonary Tuberculosis","authors":"L. N. Savonenkova, D. Kolchin, V. Ruzov, N. A. Slobodnyuk, O. Y. Prokhorov, S. V. Anisimova","doi":"10.58838/2075-1230-2023-101-6-13-19","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-13-19","url":null,"abstract":"The objective: to determine the significance of chronic cor pulmonale (CCP) as a cause of death in pulmonary tuberculosis patients.Subjects and Methods. Out of 194 autopsies of tuberculosis patients who died in Hospital no. 1 of Ulyanovsk Regional Clinical TB Dispensary in 2017-2020, autopsy reports of 87 patients with pathomorphological signs of chronic cor pulmonale were selected. The nature and prevalence of pathomorphological manifestations of tuberculosis and the causes of deaths were analyzed. Statistical analysis of the results was performed using the STATISTICA-10. The significance of differences in the frequency of events was determined using the χ2 criterion in a four-field 2х2 table.Results. Chronic cor pulmonale was confirmed pathomorphologically in 44.8% of deceased pulmonary tuberculosis patients. Chronic cor pulmonale was diagnosed in 67.8% of patients in their lifetime, and in 32.2%, it was diagnosed post mortem. Of 87 deceased patients with pulmonary tuberculosis complicated by chronic cor pulmonale, 28.7% had fibrous cavernous pulmonary tuberculosis, 26.4% had infiltrative form and 44.9% had disseminated form of the disease. Decompensated chronic cor pulmonale leading to death was detected in 42.5% of the deceased, and it was predominant in the structure of causes of death in fibrous cavernous tuberculosis (84%), and this pathology was also found in the patients with infiltrative (52.5%) and disseminated (10.3%) pulmonary tuberculosis.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-28-33
E. Kulchavenya, S. Shevchenko, O. S. Streltsova, V. N. Krupin, A. Baranchukova
The objective: to identify structural features of genital tuberculosis in men depending on their HIV status.Subjects and Methods. The medical records of 95 patients with genitourinary tuberculosis were analyzed, and records of patients with isolated tuberculosis of the male genital organs were selected.Results. Among 95 male patients with genitourinary tuberculosis, 72 (75.8%) were HIV-negative, and 23 (24.2%) were HIV-positive. Among 72 HIV-negative male patients, 33 had isolated genital tuberculosis. Among 23 HIV-positive male patients, 9 had isolated genital tuberculosis. HIV infection had a significant impact on the structure of genital tuberculosis in male patients; among cases of isolated genital tuberculosis, tuberculosis of the testicle and its epididymis prevailed (88.9%). In HIV-negative male patients, the prostate gland was affected most often (prostate tuberculosis alone or in combination with tuberculous orchiepididymitis was diagnosed in 90.9% of patients).
{"title":"Genital Tuberculosis in Men Living with HIV","authors":"E. Kulchavenya, S. Shevchenko, O. S. Streltsova, V. N. Krupin, A. Baranchukova","doi":"10.58838/2075-1230-2023-101-6-28-33","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-28-33","url":null,"abstract":"The objective: to identify structural features of genital tuberculosis in men depending on their HIV status.Subjects and Methods. The medical records of 95 patients with genitourinary tuberculosis were analyzed, and records of patients with isolated tuberculosis of the male genital organs were selected.Results. Among 95 male patients with genitourinary tuberculosis, 72 (75.8%) were HIV-negative, and 23 (24.2%) were HIV-positive. Among 72 HIV-negative male patients, 33 had isolated genital tuberculosis. Among 23 HIV-positive male patients, 9 had isolated genital tuberculosis. HIV infection had a significant impact on the structure of genital tuberculosis in male patients; among cases of isolated genital tuberculosis, tuberculosis of the testicle and its epididymis prevailed (88.9%). In HIV-negative male patients, the prostate gland was affected most often (prostate tuberculosis alone or in combination with tuberculous orchiepididymitis was diagnosed in 90.9% of patients).","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-8-12
V. S. Burykhin, I. A. Vasilyeva, S. Sterlikov, V. Testov, V. Kudrina, N. D. Urushadze
The objective: to study the conditions of implementation of short-course (4 and 9 months) treatment regimens in tuberculosis patients and simulate their impact on the frequency of early treatment interruption (ETI) by patients.Subjects and Methods. Data on the treatment duration from enrollment to chemotherapy interruption in 8,029 tuberculosis patients were studied. Data were obtained from the Federal Register of Tuberculosis Cases for 2020. Of these, 3,379 patients were treated with regimens for susceptible or suspected susceptible tuberculous mycobacteria excluding isoniazid resistant tuberculosis, and 4,650 patients received regimens for rifampicin-resistant tuberculous mycobacteria.Results. The median duration of treatment from onset to ETI was 124 (95% CI 120-128) days in 3,379 patients, 224 (95% CI 215-233) days in 4,650 patients, or 170 (95% CI 157-181) days if there was a history of treatment interruption. Simulation of ETI terms when short-course chemotherapy regimens were introduced has shown that we can expect a 2-fold decrease in the proportion of patients who interrupted chemotherapy among patients with preserved/suspected susceptibility of tuberculous mycobacteria, and 1.3-1.7-fold decrease among patients with confirmed/presumed drug resistance of tuberculous mycobacteria at least to rifampicin.
目的：研究结核病患者实施短疗程（4 个月和 9 个月）治疗方案的条件，并模拟其对患者早期中断治疗（ETI）频率的影响。研究了 8029 名肺结核患者从入院到化疗中断的治疗时间数据。数据来自《2020 年联邦结核病例登记册》。其中，3379 名患者接受了针对易感或疑似易感结核分枝杆菌（不包括耐异烟肼结核病）的治疗方案，4650 名患者接受了针对耐利福平结核分枝杆菌的治疗方案。3379 名患者从发病到 ETI 的中位治疗时间为 124 天（95% CI 120-128），4650 名患者为 224 天（95% CI 215-233），如果有治疗中断史，则为 170 天（95% CI 157-181）。对采用短程化疗方案时的 ETI 条款进行的模拟显示，我们可以预计，在结核分枝杆菌保留/疑似易感性的患者中，中断化疗的患者比例将下降 2 倍，而在结核分枝杆菌至少对利福平确诊/推测耐药的患者中，中断化疗的患者比例将下降 1.3-1.7 倍。
{"title":"Simulation of Conditions and Results of Implementation of Short-Course Treatment Regimes in Tuberculosis Patients","authors":"V. S. Burykhin, I. A. Vasilyeva, S. Sterlikov, V. Testov, V. Kudrina, N. D. Urushadze","doi":"10.58838/2075-1230-2023-101-6-8-12","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-8-12","url":null,"abstract":"The objective: to study the conditions of implementation of short-course (4 and 9 months) treatment regimens in tuberculosis patients and simulate their impact on the frequency of early treatment interruption (ETI) by patients.Subjects and Methods. Data on the treatment duration from enrollment to chemotherapy interruption in 8,029 tuberculosis patients were studied. Data were obtained from the Federal Register of Tuberculosis Cases for 2020. Of these, 3,379 patients were treated with regimens for susceptible or suspected susceptible tuberculous mycobacteria excluding isoniazid resistant tuberculosis, and 4,650 patients received regimens for rifampicin-resistant tuberculous mycobacteria.Results. The median duration of treatment from onset to ETI was 124 (95% CI 120-128) days in 3,379 patients, 224 (95% CI 215-233) days in 4,650 patients, or 170 (95% CI 157-181) days if there was a history of treatment interruption. Simulation of ETI terms when short-course chemotherapy regimens were introduced has shown that we can expect a 2-fold decrease in the proportion of patients who interrupted chemotherapy among patients with preserved/suspected susceptibility of tuberculous mycobacteria, and 1.3-1.7-fold decrease among patients with confirmed/presumed drug resistance of tuberculous mycobacteria at least to rifampicin.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-42-49
O. Savushkina, E. S. Muravieva, S. Avdeev, I. T. Kulagina, M. Malashenko, A. Zaytsev
The objective: to define the type and evaluate the severity of respiratory functional disorders after COVID-19. Subjects and Methods. A retrospective observational study was conducted. The following parameters were analyzed: demographic data, data from chest computed tomography during the acute period of the disease (CTmax), parameters of pulmonary function tests (PFT) – spirometry, body plethysmography and diffusion test. Those data were collected in 341 patients, 262 (76.8%) of them were men (median age – 48 (41.5–57) years, median durtaion of Period A (onset of COVID-19 before PFT) made 53 (28.5–111) days). Depending on duration of Period A, patients were divided into three groups: Group 1 – up to 90 days (n=221), Group 2 – 90-180 days (n=80), and Group 3 – more than 180 days (n=40). In patients of Groups 1, 2 and 3, in 68.3%, 47.5% and 32,5% of cases, respectively, disorders of diffusing lung capacity were recorded, which were associated to a greater extent with CTmax, and to a lesser extent with duration of Period A. The restrictive type of ventilation disorders was observed in 33.5% and 11% of cases in Groups 1 and 2, no restriction was detected in Group 3, airway obstruction was detected in 8%, 5%, 7.5% of cases in Groups 1, 2 and 3 respectively.Conclusion. Disorder of diffusing lung capacity was the most common functional disorder of the respiratory system after COVID-19, and therefore it is advisable to include a diffusion test along with spirometry to the examination plan of such patients.
{"title":"Analysis of Respiratory System Functional Parameters at Different Time Points after COVID-19","authors":"O. Savushkina, E. S. Muravieva, S. Avdeev, I. T. Kulagina, M. Malashenko, A. Zaytsev","doi":"10.58838/2075-1230-2023-101-6-42-49","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-42-49","url":null,"abstract":"The objective: to define the type and evaluate the severity of respiratory functional disorders after COVID-19. Subjects and Methods. A retrospective observational study was conducted. The following parameters were analyzed: demographic data, data from chest computed tomography during the acute period of the disease (CTmax), parameters of pulmonary function tests (PFT) – spirometry, body plethysmography and diffusion test. Those data were collected in 341 patients, 262 (76.8%) of them were men (median age – 48 (41.5–57) years, median durtaion of Period A (onset of COVID-19 before PFT) made 53 (28.5–111) days). Depending on duration of Period A, patients were divided into three groups: Group 1 – up to 90 days (n=221), Group 2 – 90-180 days (n=80), and Group 3 – more than 180 days (n=40). In patients of Groups 1, 2 and 3, in 68.3%, 47.5% and 32,5% of cases, respectively, disorders of diffusing lung capacity were recorded, which were associated to a greater extent with CTmax, and to a lesser extent with duration of Period A. The restrictive type of ventilation disorders was observed in 33.5% and 11% of cases in Groups 1 and 2, no restriction was detected in Group 3, airway obstruction was detected in 8%, 5%, 7.5% of cases in Groups 1, 2 and 3 respectively.Conclusion. Disorder of diffusing lung capacity was the most common functional disorder of the respiratory system after COVID-19, and therefore it is advisable to include a diffusion test along with spirometry to the examination plan of such patients.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-20-27
V. Aksenova, N. Klevno, A. Kazakov, A. Pakhlavonova, V. A. Romanenko, N. Nikolenko
The objective: to determine the effectiveness and safety (tolerability) of non-injection chemotherapy regimens containing bedaquiline in pediatric patients with multiple drug resistant respiratory tuberculosis.Subjects and Methods. Effectiveness and safety of treatment regimens containing non-injection drugs and Bdq were studied in 45 children from Main Group (MG) aged from 5 to 17 years old inclusive who were ill with multiple drug resistant tuberculosis. Control Group (CG) included patients of the same age with MDR TB who were treated with chemotherapy regimens containing injectable drugs (a retrospective study).Results. After 24 weeks (the period during which patients took bedaquiline), clinical effectiveness of chemotherapy regimens was achieved in all patients. By the end of week 24 of treatment, significant positive radiographic changes were noted in 84.4% of patients in MG and in 75.7% in CG (OR 1.741; 95% CI 0.658–4.611), healing of cavities was achieved in 42 (93.3%) and 66 (94.3%) patients, respectively (OR 0.848, 95% CI 0.181-3.982). No tuberculous mycobacteria were not detected in 100% of cases in both groups by month 6 of chemotherapy. The number of adverse reactions (AR) per patient averaged 1.25 and 1.26 in MG and CG. ARs occurred in patients receiving aminoglycosides in 41.4%: in MG – in 33.3%; 4/70 (5.7%) children from CG receiving injectable drugs developed adverse reactions requiring replacement of anti-tuberculosis drugs. No irreversible ARs were observed in MG.
{"title":"Non-Injection Chemotherapy Regimens for Drug Resistant Tuberculosis in Children and Adolescents","authors":"V. Aksenova, N. Klevno, A. Kazakov, A. Pakhlavonova, V. A. Romanenko, N. Nikolenko","doi":"10.58838/2075-1230-2023-101-6-20-27","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-20-27","url":null,"abstract":"The objective: to determine the effectiveness and safety (tolerability) of non-injection chemotherapy regimens containing bedaquiline in pediatric patients with multiple drug resistant respiratory tuberculosis.Subjects and Methods. Effectiveness and safety of treatment regimens containing non-injection drugs and Bdq were studied in 45 children from Main Group (MG) aged from 5 to 17 years old inclusive who were ill with multiple drug resistant tuberculosis. Control Group (CG) included patients of the same age with MDR TB who were treated with chemotherapy regimens containing injectable drugs (a retrospective study).Results. After 24 weeks (the period during which patients took bedaquiline), clinical effectiveness of chemotherapy regimens was achieved in all patients. By the end of week 24 of treatment, significant positive radiographic changes were noted in 84.4% of patients in MG and in 75.7% in CG (OR 1.741; 95% CI 0.658–4.611), healing of cavities was achieved in 42 (93.3%) and 66 (94.3%) patients, respectively (OR 0.848, 95% CI 0.181-3.982). No tuberculous mycobacteria were not detected in 100% of cases in both groups by month 6 of chemotherapy. The number of adverse reactions (AR) per patient averaged 1.25 and 1.26 in MG and CG. ARs occurred in patients receiving aminoglycosides in 41.4%: in MG – in 33.3%; 4/70 (5.7%) children from CG receiving injectable drugs developed adverse reactions requiring replacement of anti-tuberculosis drugs. No irreversible ARs were observed in MG.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-56-65
A. Starshinova, I. Dovgalyuk, N. N. Osipov, D. Kudlay
The COVID-19 pandemic has led to the discontinuation of many support programs for tuberculosis patients worldwide, and lower coverage of population with screening for tuberculosis.The objective: To build a model describing the spread of tuberculosis depending on the population coverage with preventive screening, and to obtain a long-term forecast of the infection spread using this model.Subjects and Methods. We analyzed official statistical data on incidence, mortality, preventive screening coverage (PSC), and revalence of sputum smear-positive tuberculosis in the Russian Federation from 2008 to 2021. The model was built up based on fluctuations in those rates in 2020, when there was a sharp reduction in tuberculosis control interventions due to the COVID-19 pandemic. Statistical analysis was performed using the R Software (v.4.2.1).Results. A simple mathematical model describing the dependence of incidence and sputum smear-positive tuberculosis in the current year on sputum smear-positive tuberculosis in the past year and population coverage with preventive screening in the current and past years was built up. The adjusted coefficient of determination of the model (adjusted R-squared) was 0.9969, which meant that the model contained almost no random components. It showed that tuberculosis cases missed due to low population coverage with preventive screening lead to future spread of tuberculous infection and a significant increase in the number of new tuberculosis cases. Comparison of projected rates and data for 2022 demontrated correct formation of models. However, the projected rates were slightly higher than the actual rates for 2022 due to the influence of factors other than the population coverage with preventive screening for tuberculosis.Conclusions. The findings demonstrate the need for mass screening of the population in the context of significant spread of tuberculosis infection for timely detection of patients with sputum smear-positive tuberculosis.
COVID-19 大流行导致全球许多肺结核病人支持计划的终止，以及肺结核筛查人口覆盖率的降低：目标：建立一个模型，描述结核病的传播取决于预防性筛查的人口覆盖率，并利用该模型对感染传播进行长期预测。我们分析了 2008 年至 2021 年俄罗斯联邦痰涂片阳性肺结核发病率、死亡率、预防性筛查覆盖率（PSC）和重测率的官方统计数据。2020 年，由于 COVID-19 大流行，结核病控制干预措施急剧减少，根据这些比率的波动建立了模型。统计分析使用 R 软件（v.4.2.1）进行。建立了一个简单的数学模型，该模型描述了当年肺结核发病率和痰涂片阳性肺结核发病率与上一年痰涂片阳性肺结核发病率以及当年和上一年预防性筛查人口覆盖率之间的关系。模型的调整决定系数（调整 R 平方）为 0.9969，这意味着模型几乎不包含随机成分。结果表明，由于预防性筛查的人口覆盖率低而漏诊的结核病例会导致未来结核感染的传播，并使结核病新病例的数量显著增加。对预测率和 2022 年数据的比较表明，模型的建立是正确的。然而，由于结核病预防性筛查人口覆盖率之外的其他因素的影响，预测比率略高于 2022 年的实际比率。研究结果表明，在结核病感染严重蔓延的情况下，有必要对人口进行大规模筛查，以便及时发现痰涂片阳性的结核病患者。
{"title":"Lessons Learned from the COVID-19 Pandemic: Simulation of the Tuberculosis Epidemic as a Function of Population Coverage with Screening","authors":"A. Starshinova, I. Dovgalyuk, N. N. Osipov, D. Kudlay","doi":"10.58838/2075-1230-2023-101-6-56-65","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-56-65","url":null,"abstract":"The COVID-19 pandemic has led to the discontinuation of many support programs for tuberculosis patients worldwide, and lower coverage of population with screening for tuberculosis.The objective: To build a model describing the spread of tuberculosis depending on the population coverage with preventive screening, and to obtain a long-term forecast of the infection spread using this model.Subjects and Methods. We analyzed official statistical data on incidence, mortality, preventive screening coverage (PSC), and revalence of sputum smear-positive tuberculosis in the Russian Federation from 2008 to 2021. The model was built up based on fluctuations in those rates in 2020, when there was a sharp reduction in tuberculosis control interventions due to the COVID-19 pandemic. Statistical analysis was performed using the R Software (v.4.2.1).Results. A simple mathematical model describing the dependence of incidence and sputum smear-positive tuberculosis in the current year on sputum smear-positive tuberculosis in the past year and population coverage with preventive screening in the current and past years was built up. The adjusted coefficient of determination of the model (adjusted R-squared) was 0.9969, which meant that the model contained almost no random components. It showed that tuberculosis cases missed due to low population coverage with preventive screening lead to future spread of tuberculous infection and a significant increase in the number of new tuberculosis cases. Comparison of projected rates and data for 2022 demontrated correct formation of models. However, the projected rates were slightly higher than the actual rates for 2022 due to the influence of factors other than the population coverage with preventive screening for tuberculosis.Conclusions. The findings demonstrate the need for mass screening of the population in the context of significant spread of tuberculosis infection for timely detection of patients with sputum smear-positive tuberculosis.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-34-41
N. V. Yatskevich, G. L. Gurevich, E. M. Skryagina, E. Gurbanova
The objective: to evaluate the effectiveness of 39- and 24-week treatment regimens in patients with multiple drug resistant or rifampicin-resistant tuberculosis (MDR/RR-TB).Subjects and Methods. We evaluated the effectiveness of 39- and 24-week treatment regimens containing bedaquiline, levofloxacin, linezolid, clofazimine, and cycloserine or delamanid (modified short-course regimens - mSCR) and bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM), in cohorts of patients with MDR/RR-TB. Results. Of the 550 and 139 patients were included in the mSCR and SMARRTT Studies (BPaLM regimen) from December 2019 to October 2021 and from March 2022 to August 2022, 90.7% (487/537) and 94.2% (131/139) achieved a successful treatment outcome, respectively, 13 patients were excluded from the mSCR Study and continued treatment according to an individual regimen. Median (ME) and quartiles [Q1-Q3] of sputum culture conversion time in patients treated with mSCR and BPaLM made 30.0 (25.0-56.0) and 27.0 (25.0-29.8) days (p<0.01) respectively. The prognostic factor for an unfavorable outcome for the BPaLM and mSCR regimens was a positive sputum microscopy result before treatment (OR – 7.92, 95% CI 1.5 – 41.0, p = 0.014; OR – 1.97, 95% CI 1.1–3.5, p=0.02, respectively), and for the mSCR regime, the time of sputum culture conversion >90 days was an additional prognostic factor (OR – 3.35, 95% CI 1.2–9.5, p=0.03) .Conclusions. The effectiveness of the mSCR and BPaLM regimens in patients with MDR/RR-TB is high (90.7% and 94.2%, respectively). Patients with positive sputum microscopy and late sputum culture conversion have a lower chance of cure.
目的：评估39周和24周治疗方案对耐多药或耐利福平结核病（MDR/RR-TB）患者的疗效。我们在MDR/RR-TB患者群中评估了包含贝达喹啉、左氧氟沙星、利奈唑胺、氯法齐明、环丝氨酸或地拉那米（改良短程方案-mSCR）以及贝达喹啉、丙托马尼、利奈唑胺和莫西沙星（BPaLM）的39周和24周治疗方案的有效性。研究结果在2019年12月至2021年10月和2022年3月至2022年8月纳入mSCR和SMARRTT研究（BPaLM方案）的550名和139名患者中，分别有90.7%（487/537）和94.2%（131/139）的患者取得了成功的治疗结果，13名患者被排除在mSCR研究之外，继续按照个体方案进行治疗。接受mSCR和BPaLM治疗的患者痰培养转换时间的中位数（ME）和四分位数[Q1-Q3]分别为30.0（25.0-56.0）天和27.0（25.0-29.8）天（P90天是一个额外的预后因素（OR - 3.35，95% CI 1.2-9.5，P=0.03））。mSCR和BPaLM方案对MDR/RR-TB患者的有效率很高（分别为90.7%和94.2%）。痰镜检阳性和晚期痰培养转阴的患者治愈几率较低。
{"title":"Evaluation of Effectiveness of 9- and 6-Month Treatment Regimens in Patients with Multiple Drug Resistant or Rifampicin-Resistant Tuberculosis in the Republic of Belarus","authors":"N. V. Yatskevich, G. L. Gurevich, E. M. Skryagina, E. Gurbanova","doi":"10.58838/2075-1230-2023-101-6-34-41","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-34-41","url":null,"abstract":"The objective: to evaluate the effectiveness of 39- and 24-week treatment regimens in patients with multiple drug resistant or rifampicin-resistant tuberculosis (MDR/RR-TB).Subjects and Methods. We evaluated the effectiveness of 39- and 24-week treatment regimens containing bedaquiline, levofloxacin, linezolid, clofazimine, and cycloserine or delamanid (modified short-course regimens - mSCR) and bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM), in cohorts of patients with MDR/RR-TB. Results. Of the 550 and 139 patients were included in the mSCR and SMARRTT Studies (BPaLM regimen) from December 2019 to October 2021 and from March 2022 to August 2022, 90.7% (487/537) and 94.2% (131/139) achieved a successful treatment outcome, respectively, 13 patients were excluded from the mSCR Study and continued treatment according to an individual regimen. Median (ME) and quartiles [Q1-Q3] of sputum culture conversion time in patients treated with mSCR and BPaLM made 30.0 (25.0-56.0) and 27.0 (25.0-29.8) days (p<0.01) respectively. The prognostic factor for an unfavorable outcome for the BPaLM and mSCR regimens was a positive sputum microscopy result before treatment (OR – 7.92, 95% CI 1.5 – 41.0, p = 0.014; OR – 1.97, 95% CI 1.1–3.5, p=0.02, respectively), and for the mSCR regime, the time of sputum culture conversion >90 days was an additional prognostic factor (OR – 3.35, 95% CI 1.2–9.5, p=0.03) .Conclusions. The effectiveness of the mSCR and BPaLM regimens in patients with MDR/RR-TB is high (90.7% and 94.2%, respectively). Patients with positive sputum microscopy and late sputum culture conversion have a lower chance of cure.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-102-110
G. Mozhokina, A. Samoylova, I. A. Vasilyeva, A. Abramchenko
The review presents the analysis of 50 publications describing treatment of multiple drug resistant tuberculosis with regimens containing the new drug of delamanid. Delamanid possesses a dual bactericidal effect not only against active but also dormant Mycobacterium tuberculosis. The results of clinical studies on the efficacy and safety of delamanid within comprehensive chemotherapy are presented. The review demonstrates prospects for expanding the use of delamanid for treatment of adults and children.
{"title":"Delamanid: Safety and Efficacy Analysis","authors":"G. Mozhokina, A. Samoylova, I. A. Vasilyeva, A. Abramchenko","doi":"10.58838/2075-1230-2023-101-6-102-110","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-102-110","url":null,"abstract":"The review presents the analysis of 50 publications describing treatment of multiple drug resistant tuberculosis with regimens containing the new drug of delamanid. Delamanid possesses a dual bactericidal effect not only against active but also dormant Mycobacterium tuberculosis. The results of clinical studies on the efficacy and safety of delamanid within comprehensive chemotherapy are presented. The review demonstrates prospects for expanding the use of delamanid for treatment of adults and children.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-66-72
O. Baronova, V. Aksenova, N. Klevno, S. V. Smerdin
The objective: to evaluate the effectiveness and safety of preventive treatment with fixed-dose combination of anti-tuberculosis drugs (FDCs) in children from groups at high risk of developing tuberculosis.Subjects and Methods. Effectiveness of preventive treatment was analyzed in 318 children from groups at high risk of developing tuberculosis. Also, we studied the possibility of successful completion of the full course of treatment using FDCs and preventive treatment regimens containing at least two single drugs. Inclusion criteria were as follows: the child at high risk of developing tuberculosis; no clinical and radiological signs of active tuberculosis; lack of information about the resistance to first-line drugs at the suspected source of infection; and negative HIV status. A group of children (172 people) underwent preventive treatment using FDCs, of them 126 patients received FDCs containing isoniazid 150 mg + pyrazinamide 500 mg + pyridoxine hydrochloride 15 mg, and 46 patients received FDCs containing isoniazid 150 mg + ethambutol 400 mg + pyridoxine hydrochloride 15 mg. The comparison group (CG) included 146 children who received preventive treatment with single drugs: 111 children received isoniazid and pyrazinamide, and 35 children received isoniazid and ethambutol.Results. When assessing the safety and effectiveness, no statistically significant differences were found when using FDCs and single-drug regimens. 91.9% of children receiving FDCs and 86.3% of children receiving single-drug regimens successfully completed the full course of treatment. When taking FDCs, there was a tendency to lower incidence of adverse events. With the FDC (isoniazid 150 mg + pyrazinamide 500 mg + pyridoxine hydrochloride 15 mg), the proportion of adverse events did not exceed 4.0%. There were no adverse events with the FDC (isoniazid 150 mg + ethambutol 400 mg + pyridoxine hydrochloride 15 mg).Conclusion. Preventive treatment of children with tuberculosis infection with FDC is a modern and effective technology.
{"title":"Experience of Fixed-Dose Combinations of Anti-Tuberculosis Drugs for Preventive Treatment in Children","authors":"O. Baronova, V. Aksenova, N. Klevno, S. V. Smerdin","doi":"10.58838/2075-1230-2023-101-6-66-72","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-66-72","url":null,"abstract":"The objective: to evaluate the effectiveness and safety of preventive treatment with fixed-dose combination of anti-tuberculosis drugs (FDCs) in children from groups at high risk of developing tuberculosis.Subjects and Methods. Effectiveness of preventive treatment was analyzed in 318 children from groups at high risk of developing tuberculosis. Also, we studied the possibility of successful completion of the full course of treatment using FDCs and preventive treatment regimens containing at least two single drugs. Inclusion criteria were as follows: the child at high risk of developing tuberculosis; no clinical and radiological signs of active tuberculosis; lack of information about the resistance to first-line drugs at the suspected source of infection; and negative HIV status. A group of children (172 people) underwent preventive treatment using FDCs, of them 126 patients received FDCs containing isoniazid 150 mg + pyrazinamide 500 mg + pyridoxine hydrochloride 15 mg, and 46 patients received FDCs containing isoniazid 150 mg + ethambutol 400 mg + pyridoxine hydrochloride 15 mg. The comparison group (CG) included 146 children who received preventive treatment with single drugs: 111 children received isoniazid and pyrazinamide, and 35 children received isoniazid and ethambutol.Results. When assessing the safety and effectiveness, no statistically significant differences were found when using FDCs and single-drug regimens. 91.9% of children receiving FDCs and 86.3% of children receiving single-drug regimens successfully completed the full course of treatment. When taking FDCs, there was a tendency to lower incidence of adverse events. With the FDC (isoniazid 150 mg + pyrazinamide 500 mg + pyridoxine hydrochloride 15 mg), the proportion of adverse events did not exceed 4.0%. There were no adverse events with the FDC (isoniazid 150 mg + ethambutol 400 mg + pyridoxine hydrochloride 15 mg).Conclusion. Preventive treatment of children with tuberculosis infection with FDC is a modern and effective technology.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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