Pathophysiology
doi: 10.25005/2074-0581-2018-20-2-3-249-253
EFFICIENCY OF INTRODUCTION OF ACTIVE SCREENING AND EXPRESS METHODS OF DETECTING OF TUBERCULOSIS IN THE REPUBLIC OF TAJIKISTAN

F.O. Mirzoeva

Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan

Objective: To study the effectiveness of using active screening in identifying people with suspected tuberculosis, as well as express methods for diagnosing patients with tuberculosis in the Republic of Tajikistan.

Methods: This study included persons who applied for medical institutions to primary health care (PHC) facilities for the period from 2011 to 2015 years in Dushanbe, Tursunzade, Khujand, Kanibadam and the regions of Gonchi, Mastchoh and Rudaki, which were screened for complaints and anamnestic data. All persons suspected of having tuberculosis underwent a complete clinical, x-ray examination and sputum research by two quick methods (microscopically and on the GeneXpert device), as well as sowing culture with subsequent determination of drug resistance on the Bactec MGIT apparatus.

Results: Under our observations, there were 214,434 persons with suspicion of tuberculosis, from among which it was revealed 22,349 patients with different clinical forms of tuberculosis, which amounted to 10.4%. In the observed group of men there were 13887 (62.1%), women – 8462 (37.9%). Of the total number of patients, most (n=14100) included in the age group 19-44 years (63.1%) and 8249 people (36.9%) were from the age group of 45-69 years. Of the 22,349 tuberculosis patients, 65.5% suffered pulmonary tuberculosis with bacterial excretion, 25.1% – pulmonary tuberculosis without bacterial excretion and 9.4% – extrapulmonary tuberculosis. In 7.3% of cases, multiple drug resistance was detected, and in 92 patients (0.41%) – a combination of the active form of tuberculosis with HIV infection. Comparative study of the detection rate of new cases of tuberculosis over the same period in the study regions exceeded this indicator in other representative control regions twice. The beginning of the treatment after verification of the diagnosis was 3 days.

Conclusion: The introduction of active screening in institutions of PHC facilities promotes a more effective integration of the phthisiatric services with the network of institutions of PHC facilities. In the implementation of active screening in 10.4% of cases, varifies different clinical forms of the disease.

Keywords: Tuberculosis, screening, express methods, PHC, integration.

Download file:

References
  1. Electronic recording and reporting for tuberculosis care and control. WHO: Geneva; 2012: 76 p.
  2. Global Tuberculosis Control. WHO: Geneva; 2017. р. 186-211.
  3. Zdorov’e naseleniya i deyatel’nost’ uchrezhdeniy zdravookhraneniya v 2017 godu [Health of the population and the activities of health facilities in 2017]. Dushanbe, RT: Irfon; 2018. 384 p.
  4. Early detection of tuberculosis: an overview of approaches, guidelines and tool. WHO: Geneva; 2011. 19 р.
  5. Pavlunin АV, Sharafutdinova МА, Borisova SB, Mishanov RF, Меdovarov ЕV. Problemy organizatsii viyavleniya i diagnostiki tu-berkulyoza lyogkikh v obshey lechebnoy seti [The problems of organiz-ing the detection and diagnosis of pulmonary tuberculosis in the general treatment network]. Tuberkulyoz i bolezni lyogkikh. 2014;11:41-8.
  6. Podgaeva VА, Golubev DN. Integral’nyy pokazatel’ organizatsii i effek-tivnosti profilaktiki tuberkulyoza kak indikator rezul’tativnosti raboty uchrezhdeniy obshchey lechebnoy seti i protivituberkulyoznoy sluzhby Urala [The integral indicator of the organization and effectiveness of tu-berculosis prevention as an indicator of the effectiveness of the institu-tions of the general medical network and the anti-tuberculosis service of the Urals]. Ftiziatriya i Pul’monologiya. 2011;2:64-5.
  7. Cattamanchi A, Davis JL, Pai M, Huang L, Hopewell PC. Does bleach processing increase the accuracy of sputum smear microscopy for di-agnosing pulmonary tuberculosis. J Clin Microbiol. 2010;48:2433-9.
  8. Dowdy DW, Basu S, Andrews JR. Is passive diagnosis enough? The impact of subclinical disease on diagnostic strategies for tuberculosis. Am J Respir Crit Care Med. 2013;5:543-51.
  9. Denkinger CM, Nicolau I, Ramsay A, Chedore P, Pai M. Are peripheral microscopy centres ready for next generation molecular tuberculosis diagnostics? Eur Respir J. 2013;42(2):544-7.
  10. Kik SV, Denkinger CM, Chedore P, Pai M. Replacing smear microscopy for the diagnosis of tuberculosis: what is the market potential? Eur Respir J. 2014;43(6):1793-6.
  11. Creswell JH, Sahu S, Blok L, Bakker MI, Stevens R, Ditiu L. A Multi-site evaluation of innovative approaches to increase tuberculosis case notification: summary results. PLoS One. 2014;10(2):111-4.
  12. Dushina ЕV, Khantaeva NS, Galimov SA, Мikhalyova LV. Rol’ resursnogo obespecheniya lechebno-profilakticheskikh meditsinskikh organizatsiy v povyshenii effektivnosti aktivnogo viyavleniya tuberkulyoza sredi naseleniya [Role of resource provision of medical and preventive medical organizations in increasing the effectiveness of active detection of tuberculosis among the population]. Tuberkulyoz i bolezni lyogkikh. 2015;6:57-8.
  13. Uplekar M, Creswell J, Ottmani S-E, Weil D, Sahu S, Lunnroth K. Programmatic approaches to screening for active tuberculosis. Int J Tuberc Lung Dis. 2013;17(10):1248-56.
  14. Blok L, Creswell J, Stevens R, Brouwer M, Ramis O, Weil O, et al. A pragmatic approach to measuring, monitoring and evaluating interven-tions for improved tuberculosis case detection. Int Health. 2014;6(3):181-8.
  15. Tarashkevich NV, Kamenko ЕS. Effektivnost’ molekulyarno-geneticheskogo metoda GeneXpert MTB/RIF dlya diagnostiki tuberkulyoza [The effectiveness of the molecular genetic method GeneX-pert MTB / RIF for the diagnosis of tuberculosis]. Molodoy uchyonyy. 2014;2:68-70.
  16. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system. Geneva, WHO; 2011. 88 p.
  17. Vassall A, van Canpen S, Sohn H. Rapid diagnosis of tuberculosis with the Xpert MTB/RIF assay in high burden countries: a cost effec-tiveness analysis. PLoS Med. 2011.e1001120.
  18. Xpert MTB/RIF implementation manual. Technical and operational “how-to”: practical considerations. WHO: Geneva; 2014. 42 p.
  19. Weyer K, Mirzayev F, Migliori GB, Van Gemert W, D’Ambrosio L, Zignol M. Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF. Eur Respir J.2013;42(1):252-71.
  20. Kranzer K, Afnan-Holmes H, Tomlin K. The benefits to communities and individuals of screening for active tuberculosis disease: a systematic review. Int J Tuberc Lung Dis. 2013;17:432-46.
  21. Golub JE, Dowdy DW. Screening for active tuberculosis: methodological challenges in implementation and evaluation. Int J Tuberc Lung Dis. 2013;17:856-65.
  22. Van Rie A, Hanrahan C. Active case finding for tuberculosis: what is the most informative measure for policy makers? Int J Tuberc Lung Dis. 2014;18(3):377-8.
  23. Small P, Pai M. Tuberculosis diagnosis – time for a game change. N Engl J Med. 2010; 363:1070-1.
  24. Zhang X, Wei X, Zou G. Evaluation of active tuberculosis case finding through symptom screening and sputum microscopy of close contacts in Shandong, China. Trop Med Int Health. 2011;16(12):1511-7.
  25. Azman AS, Golub JE, Dowdy DW. How much is tuberculosis screening worth? Estimating the value of active case finding for tuberculosis in South Africa, China, and India. BMC Med. 2014;12(1):216.
  26. Hoog AH, Meme HK, Laserson KF. Screening strategies for tuberculosis prevalence surveys: the value of chest radiography and symptoms. PLoS One. 2012;7(7):e38691.

Authors' information:

Mirzoeva Farangiz Oktamovna,
Master of Public Health, Doctoral PhD, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan

Conflicts of interest: No conflict

Address for correspondence:

Mirzoeva Farangiz Oktamovna

Master of Public Health, Doctoral PhD, Institute of Postgraduate Education in Healthcare of the Republic of Tajikistan

734026, Republic of Tajikistan, Dushanbe, Somoni Ave., 59

Tel.: (+992) 985 868080

E-mail: bobokhojaev@mail.ru

Materials on the topic:
  1. EXPERIMENTAL DEPRESSION-MODULATED ACTIVATION PATTERN OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS
  2. EVALUATION OF HEMATOTOXICITY OF NEW DERIVATIVES OF CONDENSED 3-AMINOTHIENO[2,3-b]PYRIDINES AND 1,4-DIHYDROPYRIDINES WITH HIGH ANALGESIC ACTIVITY
  3. LABORATORY BIOMARKERS FOR BRAIN DAMAGE IN DIABETES MELLITUS
  4. EFFECT OF ACTH6-9-PRO-GLY-PRO PEPTIDE ON SPECTRAL PARAMETERS OF HEART RATE VARIABILITY IN WISTAR RATS DURING PHYSICAL EXERTION (PILOT STUDY)
  5. IN VIVO STUDY OF WOUND-HEALING ACTIVITY OF POLYSACCHARIDE GEL WITH ENCAPSULATED SEA-BUCKTHORN OIL (HIPPOPHAE RHAMNOIDES)
  6. DYNAMICS OF DRUG RESISTANCE IN M. TUBERCULOSIS DURING THE NEW CORONAVIRUS INFECTION PANDEMIC IN DUSHANBE: THE NEED FOR URGENT MEASURES
  7. IMPLEMENTATION STUDY IN PREVENTION AND CONTROL OF DRUG-RESISTANT TUBERCULOSIS DURING THE COVID-19 PANDEMIC IN DUSHANBE
  8. PREVALENCE OF MYCOBACTERIUM TUBERCULOSIS AMONG CHILDREN AT THE RESERVOIRS OF INFECTION IN THE REPUBLIC OF TAJIKISTAN
  9. ANTITUBERCULOSIS DRUG ALLERGY IN PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS
  10. STIGMA AND DISCRIMINATION ASSOCIATED WITH TUBERCULOSIS

◄ Back to the list