OPTIMIZATION OF EPIDEMIOLOGICAL APPROACH FOR THE EXAMINATION OF PERSONS BELONGINGTO A TUBERCULOSIS INFECTION RISK ZONE
Introduction. The early detection of tuberculosis is one of the main measures preventing tuberculosis spread among the population and increasing the number of positive outcomes. The timely detection of only the one patient in a big city allows one to prevent at least 60 cases of tuberculosis infection per day.Purpose. The aim of the study was to develop measures to optimize patient’s assessment with risk of contracting tuberculosis.Materials and methods. The study was carried out within the photofluorography department in the Tuberculosis dispensary№ 12 of the Admiralteysky District of St. Petersburg, the photofluorography departments of all outpatient clinics in the Admiralteysky District of St. Petersburg, the on-site photofluorography station of the City Municipal Tuberculosis dispensary during 2010-2016. Report forms of these organizations were used.Results and discussion. During photofluorography examination in the photofluorography department of the Tuberculosis dispensary № 12 of the Admiralteysky District of St. Petersburg it was stated 10-12% of persons from a total number of risk groups, during 2010-2016 the tuberculosis detection was 1,59% (95% CI=1,3-1,9) per 1000 patients. At the same time, in the outpatient clinics of the Admiralteysky District (population at large), the tuberculosis detection was 0,25 (95% CI=0,2-0,3) per 1000 patients, that is 5 times less than in the Tuberculosis dispensary № 12.During the examinations of the working population and students conducted in the on-site photofluorography station of the City Municipal Tuberculosis dispensary (socially adapted persons of working age), the tuberculosis detection in 2010-2016 was 0,15 (95% CI=0,1-0,21) per 1000 patient, that is 9 times less, than in the Tuberculosis dispensary № 12 with the decrease from 0,19 to 0,1 (by 2 times) in 2010 to 2016.Conclusion. The economic efficiency of the examinations is significantly higher in the photofluorography department of the Tuberculosis dispensary rather than in outpatient clinics. It is necessary to separate acquaintances of the patient with a contagious form of tuberculosis into a risk group because of having a direct contact with the patient. The first group of patients has to be examined in accordance with the Ministry of Health orders № 109 and № 951. For the persons from the risk groups it is enough to undergo a photofluorography of chest and by it results determined the extent of the examination. Economic and epidemiological efficiency of this approach is quite justified.