Influence of outpatient treatment newly diagnosed pulmonary tuberculosis on the development of familial tuberculosis (epidemic situation)

Abstract

The incidence of tuberculosis in our country, according to statistics, seems to be declining. However, it should be remembered that the figures of the Crimean Autonomous Republic and the temporarily occupied territories of Donetsk and Luhansk oblasts are excluded from the digital data. Of particular concern are the significant worldwide morbidity and infant mortality rate of 700 people per day.The problem’s urgency is due to the data and the increase in the number of patients with common and destructive forms of pulmonary tuberculosis. The leading factor is the constant increase in the number of patients with multidrug­resistant conditions, the effectiveness of treatment of which does not reach 50%. In comparison, the WHO considers the critical limit for stabilizing the epidemic situation «effective treatment» at 85 %. Objective — to study the features of familial tuberculosis on the background of outpatient treatment of patients with newly diagnosed tuberculosis. Materials and methods. We observed 157 families with various forms of pulmonary tuberculosis. Radiation, bacteriological, immuno­genetic methods were used in the examination. Family members were examined every six months. Results and discussion. Among the TB contacts after this period, tuberculosis was found in 162 people. Sources of tuberculosis (157) were bacillary in 49.7 %, TB contacts — in 43.8 %. Among patients in the group of heads of tuberculosis, there were 28 (35.9 %) people on MRTB, and in the group of TB contacts — 32 (45.1 %), р < 0.05. Thus, tuberculosis’s cause in TB contacts was not isolated from the family of patients with newly diagnosed tuberculosis. Conclusions. Based on the results obtained, it is safe to say that if at least fixed bacillary patients were hospitalized, there could be no family TB contact patients. Comparing all sources of tuberculosis patients (157), it can be imagined that cases of familial tuberculosis (162) could be avoided. Nature «responded» to ignoring one part of the epidemic process (transmission of infection that increases with contact) by increasing the number of patients with familial tuberculosis by 5 people. We note: it was only about the Sumy region and only for a limited time.