ГБОУ ВО «Дагестанский государственный медицинский университет» МЗ РФ, г. Махачкала, РоссияУстойчивая тенденция улучшения эпидемической ситуации по туберкулезу за последние 15 лет в Российской Федерации, в том числе и Дагестане, привела к снижению эффективности и рентабельности периодических осмотров взрослого населения� В связи с этим назрела необходимость перегруппировки противотуберкулезных ресурсов с массовых однотипных мероприятий на адресные в группах риска� К ним в первую очередь относятся дети и подростки, ВИЧ-инфицированные, контакты из очагов с бактериовыделением, лица с остаточными туберкулезными изменениями и фоновыми заболеваниями -алкоголики, наркоманы, больные сахарным диабетом, язвенной болезнью желудка и 12-перстной кишки, хроническими неспецифическими заболеваниями легких, а также лица, имеющие плохие материально-бы-товые условия� Такую работу по модернизации противотуберкулезной службы целесообразно проводить в относительно благополучных по туберкулезу регионах с заболеваемостью ниже 40 на 100 тыс� населения� UPGRADE OF TB SERVICES IN NEW SOCIAL AND EPIDEMIC CONDITIONS T. G. GIREEV, G. K. GUSEYNOV, V. YU. KHАNАLIEV, I. А. MАMАEV, А. А. АDZIEV, KH. YU. PАKHIEVА Dagestan State Medical University, Makhachkala, RussiaIn Dagestan as in Russia in general, tuberculosis situation has been stably improving for the last 15 years, which resulted in the reduction of efficiency and cost-effectiveness of regular screening in the adult population� Due to this it is necessary to relocate tuberculosis control resources from standard mass screening to activities targeted at risk groups� First of all, these risk groups include children and adolescents, the HIV infected, those exposed to infectious cases of tuberculosis, patients with remaining post-tuberculosis changes and diseases increasing the risk of tuberculosis -those addicted to alcohol and substances, suffering from diabetes, peptic ulcer, chronic non-specific pulmonary diseases as well as those living in poor conditions� It is reasonable to perform work aimed at the upgrade of TB services in the regions with favorable TB situation with the incidence below 40 per 100,000 population� Key words: regular screening, risk groups, TB service upgrade For citations: Gireev T�G�, Guseynov G�K�, Khanaliev V�Yu�, Mamaev I�А�, Аdziev А�А�, Pakhieva Kh�Yu� Upgrade of TB services in new social and epidemic conditions� Tuberculosis and Lung Diseases, 2017, Vol� 95, no� 12, P� 44-48� (In Russ�)
During last ten years, in the Republic of Dagestan a steady decreasing of main epidemiological indices of tuberculosis (morbidity, mortality, etc.) is observed. The efficiency of treatment of patients with tuberculosis increased significantly. Besides, the new problems moved to forefront which don't fit with this trend. They are high contamination, presence of significant percentage of secondary forms of tuberculosis among children and adolescents, preservation of high morbidity of tuberculosis among individuals detected from contact with patients with BK+, annual increasing of of number of late recurrence and medication-resistant forms of tuberculosis of lungs, increasing of percentage of patients with detected mycobacterium of tuberculosis of bovine type - M.bovinus. Every one of these problems requires profound investigation for making address organizational decisions in groups of increased risk of development of tuberculosis.
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