The experience of organizing a system of anti-epidemic measures in the Russian military medical group operating on the territory of the island of Sumatra during the humanitarian operation to eliminate the effects of the tsunami in 2005 is presented. A characteristic of the consequences of a natural disaster, a climatogeographic description of the region is presented. The natural-climatic and socio-economic conditions for the spread of malaria infection in the coverage area of the Russian military medical group are analyzed. Russian military physicians acted in an equatorial climate in a zone of tropical rainforest in a highly endemic area for tropical (P. falciparum) and three-day (P. vivax) malaria, as well as for vector-borne tropical infections such as dengue fever, vuhereriosis, and brugiosis. Among the carriers of malaria parasites and other tropical infections on the territory of about. Sumatra mosquitoes Anopheles sundaicus are of the greatest epidemic importance. In 2005, their mass breeding occurred in late January - early February (1,5-2 months earlier than usual). A system of anti-malarial protection of personnel is described, aimed at reducing the risk of infection of military personnel, preventing the development of the disease and its malignant course, early detection of patients and their effective treatment. There were no cases of malaria among the Russian military personnel during their entire stay in the endemic territory. At the same time, the incidence rate among Indonesian soldiers and local residents was constantly increasing. In hospitals, the number of patients with severe forms of tropical malaria increased. Thus, the effectiveness of the developed system of anti- malarial measures among the military personnel involved in peacekeeping and humanitarian operations in the territory with a continuous season of transmission of malaria infection has been confirmed.
The objective of the study: to identify the specific parameters of hepatotoxic reactions in tuberculosis patients depending on the presence of hepatitis B and C markers in the blood. Subjects and methods. The state of the hepatobiliary system was studied in 107 HIV-negative patients with newly diagnosed infiltrative pulmonary tuberculosis in the destructive phase. The main group included 52 people with positive results of the tests for markers of viral hepatitis B and C, the comparison group included 55 people with negative results. The groups were compatible in age, volume of the lung tissue lesions, and drug resistance profile. Results. Even before the start of anti-tuberculosis therapy, in the main group had elevated levels of cholinesterase and blood amylase, ultrasound examination detected hyperechoic liver parenchyma, enlarged right lobe of the liver, liver veins fibrosis, the enlarged diameter of the cystic duct and splenic vein, and splenomegaly (p <0.05), which was statistically significantly more frequent than in the comparison group. In the course of treatment, patients of both groups developed hepatotoxic reactions, however, in the main group they were more frequent versus the comparison group (88.4 and 21.8%, respectively, p <0.05), appeared earlier on average by 14 days and were accompanied by more pronounced clinical manifestations and abnormalities of biochemical parameters.
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