Evaluation of functional disorders in tuberculosis patients with the severe course of the disease

The objective: to assess functional disorders in various models of clinical situations in patients with the severe course of tuberculosis.

Subjects and methods. Functional disorders were assessed in 154 tuberculosis patients (HIV positive or HIV negative) with a severe course of the disease, distributing them according to clinical situation models. 4 models of clinical situations for such patients were proposed: M₁ - patients with chronic forms of tuberculosis (after 2 or more treatment failures), with complications, but no severe immunodeficiency; patients with acute progressive tuberculosis without lesions of the central nervous system (CNS); M₂ - HIV positive and HIV negative patients with acute progressive tuberculosis without lesions of the central nervous system; M₃ - patients with tuberculosis and meningitis (meningoencephalitis) of various etiologies; M4 - patients with tuberculosis and chronic progressing diseases of a therapeutic profile.

Results. The scale for assessing functional deficits in tuberculosis patients allows determining the type and severity of functional disorders as well as mobility, the ability to self-service and communication in patients with a severe course of the disease. The severity of functional disorders differs in patients from different models, it is the smallest with M₁ model - a chronic course of tuberculosis, and it is the biggest in M₃ model - tuberculosis with central nervous system lesions.

The proposed models can be the basis for development of differentiated management regimens for such patients and provision of care in TB units, estimation of the demand for auxiliary care products, analgesic and symptomatic therapy, as well as compilation of algorithms for medical personnel actions.

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