TY - JOUR
T1 - Tuberculosis in Siberia
T2 - 1. An epidemiological and microbiological assessment
AU - Drobniewski, F.
AU - Tayler, E.
AU - Ignatenko, N.
AU - Paul, J.
AU - Connolly, M.
AU - Nye, P.
AU - Lyagoshina, T.
AU - Besse, C.
PY - 1996
Y1 - 1996
N2 - Setting: Siberia, Russian Federation. Objective: To assess the situation regarding tuberculosis as a paradigm for the Russian Federation. Design: Data was obtained from official sources and through visits to dispensaries and hospitals in 1994. Results: The downward trend in notifications of tuberculosis throughout Russia reversed in 1990/91, the rate increasing from 34/100,000 to 42.9/100,000 in 1993. Incidence rates are higher in Siberia, varying from approximately 43 to 108/100,000; prevalence is 250-300/100,000. The tuberculosis service is centralized and based on specialized polyclinics and dispensaries. An extensive surveillance system employs regular fluorography and tuberculin testing: half of the cases diagnosed are detected by fluorography, against 1% through contact tracing. Patients are classified principally on clinical and radiological grounds. Bacille Calmette-Guerin immunisation is performed at birth and at age 7, and again at 13, 21, and 28 years if Mantoux test is negative. Microscopy and culture services are organisationally separate, and direct comparison of smear and culture data is not possible. Drug resistance to isoniazid and streptomycin is probably high and resistance to rifampicin low, but data on susceptibility of isolates from new cases are not available. Conclusion: Tuberculosis is increasing in Siberia, Homelessness, unemployment and alcoholism are important factors, but concurrent human immunodeficiency virus (HIV) infection appears to be uncommon. Prisons probably form a significant reservoir of infectious cases.
AB - Setting: Siberia, Russian Federation. Objective: To assess the situation regarding tuberculosis as a paradigm for the Russian Federation. Design: Data was obtained from official sources and through visits to dispensaries and hospitals in 1994. Results: The downward trend in notifications of tuberculosis throughout Russia reversed in 1990/91, the rate increasing from 34/100,000 to 42.9/100,000 in 1993. Incidence rates are higher in Siberia, varying from approximately 43 to 108/100,000; prevalence is 250-300/100,000. The tuberculosis service is centralized and based on specialized polyclinics and dispensaries. An extensive surveillance system employs regular fluorography and tuberculin testing: half of the cases diagnosed are detected by fluorography, against 1% through contact tracing. Patients are classified principally on clinical and radiological grounds. Bacille Calmette-Guerin immunisation is performed at birth and at age 7, and again at 13, 21, and 28 years if Mantoux test is negative. Microscopy and culture services are organisationally separate, and direct comparison of smear and culture data is not possible. Drug resistance to isoniazid and streptomycin is probably high and resistance to rifampicin low, but data on susceptibility of isolates from new cases are not available. Conclusion: Tuberculosis is increasing in Siberia, Homelessness, unemployment and alcoholism are important factors, but concurrent human immunodeficiency virus (HIV) infection appears to be uncommon. Prisons probably form a significant reservoir of infectious cases.
UR - http://www.scopus.com/inward/record.url?scp=0029785505&partnerID=8YFLogxK
U2 - 10.1016/S0962-8479(96)90001-5
DO - 10.1016/S0962-8479(96)90001-5
M3 - Article
C2 - 8758101
AN - SCOPUS:0029785505
SN - 0962-8479
VL - 77
SP - 199
EP - 206
JO - Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
JF - Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
IS - 3
ER -
