We showed increasing HIV prevalence among TB patients in Kazakhstan. HIV was not an independent risk factor for MDR-TB, but risk factors were largely overlapping and we did identify subgroups at particular risk of HIV-MDR-TB co-infection, notably drug users. Enhanced efforts are necessary to provide care to these socially vulnerable populations.
In this article, there are given results of comparative studying of efficiency of surgical and conservative treatment of 277 patients with multidrug resistant tuberculosis. The effectiveness of the surgical treatment of the main group of patients against the background of chemotherapy with anti-TB chemotherapy with the drugs of the reserve line has been compared with two control groups: Group I-Surgical intervention was implemented with drugs of the first line, Group II-Chemotherapy was conducted with anti-TB drugs of the second line without surgical intervention. Treatment outcomes in three groups were stated after cohort investigation, and following results were obtained: Effectiveness of surgical treatment of patients of the main group with MDR TB treated with anti-TB drugs of the second line constituted 98.0% versus 53.7% in the Group II. Effectiveness of conservative treatment of patients in III (control) Group constituted 74.4%. Analysis of results obtained showed that the outcomes in the main group after regimen completed were higher by 1.8 times than in patients operated against the background of treatment with the drugs of the first line and by 1.3 times higher than effectiveness in patients in the Group III (P < 0.01). Effectiveness of the treatment in the Group II was obtained through implementation of collapsesurgical interventions. In this article, the statistical program STAT 10 was applied.
This article has described the results of studies conducted on pre-culture samples in a modified environment Shkolnikova Dorozhkova at 37˚C during 24-48 hours. It was stated that this method helps grow Mycobacterium tuberculosis, which, when sown on the medium give rise visible colonies on the 5th-7th day. These data confirm the possibility to accelerate the growth of mycobacteria and shorten the terms of diagnosing tuberculosis by 3 or 4 times thanks to pre-culturing of the diagnostic material in the experimental medium. The original conception of the Mycobacterium tuberculosis development step-by-step was elaborated which was based on changeability of mycobacteria and prominent character of their development from division of the bacterial cells to the development of the maturated cells and further biological transformation under conditions of the surrounding factors. This conception gave the explanation of the integrated picture of the biological changeability of Mycobacterium tuberculosis. It was stated that the cocci-like, flask-like, grain-like, virus-like, filtrating forms, L-forms and other agent forms are the stages of the biological development of tuberculosis mycobateria which are not always identified by the routine methods of microbiological diagnostics implemented in the veterinary practice. Thus, the use of the developed method of diagnostics of tuberculosis in animals together with agglutination test, ELISA and PCR allow shortening the terms of primary diagnosis of tuberculosis in animals by bacteriological method by 5-7 days.
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