Preview

Tuberculosis and Lung Diseases

Advanced search
Vol 98, No 12 (2020)
View or download the full issue PDF (Russian)

ORIGINAL ARTICLES

7-19 1640
Abstract

The objective: to determine the state and prospects of TB control services including the period during the COVID-19 pandemic.

Materials. Data from Federal Statistic Surveillance Forms no. 4, 8, 14, 14-DS, 30, 33, 47, and 61 were analyzed. The number of those died is presented as per the data of Rosstat.

Research methods: epidemiological and statistical analysis, expert assessment, and content analysis of publications and regulations.

Results. In Russia in the second decade of the XXI century, there was a significant improvement of tuberculosis situation. From 2010 to 2019, the reduction of the rates was the following: incidence – from 77.2 to 41.2 per 100,000 population (by 46.6%); prevalence – from 177.5 to 86.4 per 100,000 population (by 51.3%); mortality – from 15.4 to 5.1 per 100,000 population (3-fold reduction).

In recent years, one can anticipate the stabilization of HIV situation. Over 10 years (2006-2015), the average growth rate of indicators was the following: incidence – by 9.8%, prevalence at the end of the year – by 9.4%, mortality – by 26.6%. In 2016-2019, HIV incidence became stable (2019 – 54.6 per 100,000 population). In 2019, for the first time HIV mortality decreased by 2.1% and reached 13.7 per 100,000 population. The number of lethal TB/HIV co-infection cases is going down. People at the age of 15-34 fall ill (2019 – 37.6%) and die (23.6%) less often versus all new cases and those who died of HIV infection. Russia has the highest coverage of the population with HIV tests (28.5%).

Epidemics of tuberculosis and coronavirus infection are developing in the opposite directions. High rates of COVID-19 are observed in regions with low tuberculosis rates, therefore the COVID-19 pandemic will not result in the increase of tuberculosis incidence in the population that is predominantly not infected with tuberculosis. Conversely, in regions with a high level of tuberculosis infection in the population, the number of coronavirus cases is significantly lower.

In Russia, in the near future COVID-19 will not contribute to the increase in incidence and mortality of tuberculosis and HIV infection. The negative effects of the pandemic are partially offset by a sharp reduction in contacts, an increase in lung computed tomography, regular supply of anti-tuberculosis and antiretroviral drugs purchased by the state budgets of different levels, improved patients’ adherence to treatment, and the expansion of hospital-replacing technologies in specialized medical organizations.

Facilities, resources and personnel of medical TB control services make it possible to expand their functions to fulfill the goals and objectives of the RF Healthcare Development Strategy for the period up to 2025 for socially significant infectious diseases that pose a biological threat to the population (tuberculosis, HIV infections, and parenteral viral hepatitis).

20-24 792
Abstract

During the COVID-19 pandemic in the Russian Federation associated with restrictions and quarantine, in order to ensure the quality and availability of tuberculosis medical care to the population of the Republic of Sakha, it became necessary to improve and search for new organizational forms of out-patient care.

The objective of the study: to analyze the use of new technologies in out-patient care for tuberculosis patients in the Republic of Sakha (Yakutia) during the COVID-19 pandemic.

Result: Scientific Practical Phthisiology Center introduced the following information and digital technologies to ensure the availability and quality of medical services to the population of the republic during the COVID-19 pandemic: Cloud Polyclinic, Telemedical Consultations, Radiological Information System of APK ArchiMed , Video-Controlled Treatment at Home, and Hospital at Home.

All technologies have demonstrated their efficacy for remote medical consultations and contacting patients online. Based on practical experience, these technologies provided the following: improvement of medical care provided to the population through consultations, maintaining good contact with the patient, monitoring patients' well-being, and drug in-take. They assured compliance with general federal and regional anti-epidemic recommendations to prevent the spread of the new coronavirus infection.

27-32 597
Abstract

The objective of the study: to determine the role of polymorphic variants T6000A (rs2430561), T8360C (rs2069718) of the IFNG gene in the development of tuberculosis in the population of Yakut nationality.

Subjects and methods. The case-control study was conducted. The subject for the study was DNA samples from 172 tuberculosis patients (the case group) and 367 people with an excluded diagnosis of tuberculosis (the control group). All participants of the study belonged to Yakut nationality. For genotyping, DNA was isolated from venous blood. The genotyping was performed by real-time polymerase chain reaction. For statistical processing, Pearson's χ2 test and odds ratio with 95% confidence intervals were used.

The results of the study showed that the distribution of genotypes of polymorphisms T6000A (rs2430561), T8360C (rs2069718) of the IFNG gene in the case and control groups corresponded to the Hardy – Weinberg equilibrium. There was no statistically significant difference in frequencies of alleles and genotypes of polymorphisms T6000A (rs2430561), T8360C (rs2069718) of the IFNG gene in the patients from the case and control groups.

Conclusions. The results of the study did not reveal the association of alleles and genotypes of the rs2430561 and rs2069718 polymorphic variants of the IFNG gene with the risk of developing tuberculosis for people of Yakut nationality.

34-40 639
Abstract

The objective of the study: the comparative study of psychological characteristics of pulmonary tuberculosis patients with different levels of therapeutic cooperation during in-patient treatment.

Subjects and nethods. 318 pulmonary tuberculosis patients aged 18-60 years old were enrolled in the study; they all underwent in-patient treatment in Central Tuberculosis Research Institute in 2017-2019, of them 195 (61.3%) were women and 123 (38.7%) were men. In all patients, the level of therapeutic cooperation was studied using the specially designed questionnaire; psychological characteristics were assessed using certain psychodiagnostic methods.

Results. It was found that the proportion of patients with a high level of therapeutic cooperation (44.3% of cases) significantly prevailed versus patients with low (29.6% of cases) (Pearson χ2 = 9.4; p < 0.01) and moderate level of cooperation (26.1% of cases) (Pearson χ2 = 15.02; p < 0.001). A comparative study of the psychological characteristics of pulmonary tuberculosis patients demonstrating different levels of therapeutic cooperation allowed identifying psychological prognostic parameters of therapeutic cooperation, the main of which were the severity of suspicion, negative affective states (irritability, aggressiveness), distrustful-skeptical style of interaction, confrontation with others, as well as the level of quality life, primarily the emotional and social aspects of functioning. The detected psychological differences are considered as targets of psychological work focused on the formation of appropriate therapeutic cooperation during in-patient treatment.

42-46 590
Abstract

The objective of the study: to compare the efficacy of different modifications of thoracoplasty in patients with apical fibrous cavernous pulmonary tuberculosis.

Subjects and methods. The article describes the analysis of the results of thoracoplasty in 65 fibrous cavernous pulmonary tuberculosis patients performed from 2016 to 2019. Three types of thoracoplasty were used: thoracoplasty with polypropylene mesh, osteoplastic thoracoplasty, and traditional thoracoplasty. The results were assessed by the severity of intraoperative trauma, development of bronchopulmonary complications, lack of compression, and healing of cavities.

Results. No significant difference in the degree of intraoperative injury was found when comparing three types of thoracoplasty (p > 0.05). Clinical and X-ray examinations of patients in 3 weeks after surgery revealed that in thoracoplasty with a polypropylene mesh, the frequency of bronchopulmonary complications and lack of compression was lower than in other types of thoracoplasty (p < 0.05). Using the patient's own tissues for extrapleural fixation, especially with large cavities, results in a significant decrease in the thoracoplasty efficacy.

48-52 516
Abstract
To evaluate the degree of tuberculous lesions of the lungs, the method has been developed for coding and quantitative assessment of chest computed tomography results (chest CT) based on the presence of the following signs in each lobe of the lung: infiltrative and/or small focal changes – +1 point, focal formations (tuberculomas) – +2 points, cavitary changes (cavities) – +4 points. If there are all elements in the lobe, the maximum score is given – 7. The X-ray signs of tuberculous changes in the lungs are recorded in the form of a five-digit code "* * * | * *", where * corresponds to the lung lobe and is replaced by a figure corresponding to the total score calculated for this lobe. The arithmetic mean of the numbers in the code allows estimating the dissemination of tuberculosis: the higher the value, the more severe pathological changes in the lungs. The authors experimentally found that in the treatment of multiple and extensive drug resistant pulmonary tuberculosis with, the timing of sputum conversion (rs = 0.442; p < 0.01) and healing of cavities (rs = 0.575; p < 0.05) directly depended on the severity of tuberculous changes in the lungs, revealed by chest CT and evaluated using the proposed method.
53-56 978
Abstract

The objective of the study: to compare the diagnostic value of intracutaneous tests with tuberculin and diaskintest for detection of tuberculosis in cattle.

Subjects and methods. In this study, PPD tuberculin for mammals was used, it was made from M. bovis strain AN-5, manufactured by BIOK, and Diaskintest (recombinant tuberculous allergen, solution forintracutaneous administration) manufactured by ZAO FF Lecco, series 030307.

Laboratory animals (guinea pigs, rabbits, chickens) and farm animals (pigs and cattle) were used in the study.

Results. It has been established on laboratory animals that diaskintest does not cause any adverse events. When assessing sows sensitized with M. avium, it was found that the intracutaneous administration of PPD tuberculin to mammals resulted in up to 8.5% of positive reactions, while diaskintest was negative in all of them. Among cattle sensitized to non-tuberculous mycobacteria, intracutaneous administration of tuberculin for mammals revealed up to 4.6% of positive reactions, and diaskintest – up to 0.6%. In the farm with the unfavorable TB situation where animals infected with M. bovis were previously detected, when examining 177 cows, tuberculin test was positive in 102 (57.6%) of them, and diaskintest in 88 (49.7%). Diaskintest can be used for differential diagnosis of tuberculosis and sensitization by non-tuberculous mycobacteria in pigs and cattle.

LITERATURE REVIEW

57-66 2128
Abstract
The article presents a review of 70 publications. It describes relevant data on drugs, timing, indications, efficacy, and safety of short-term treatment regimens for multiple drug resistant tuberculosis.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-1230 (Print)
ISSN 2542-1506 (Online)