Severe cases of tuberculosis and improving the efficiency of treatment in the application of the standard schemes
Journal Title: Туберкульоз, легеневі хвороби, ВІЛ-інфекція - Year 2018, Vol 0, Issue 2
Abstract
Objective — was to analyze the prevalence of severe cases of tuberculosis and the situation of comorbidity with various variants of concomitant pathology, substantiation of ways of influence for increase of efficiency of treatment at application of standard schemes. Materials and methods. A retrospective analysis was conducted for 2015—2017 electronic database of patients’ registry and medical records of a stationary patient in Chernivtsi Regional Clinical Antituberculosis Dispensary. Results and discussion. Associated diseases of the digestive system are found in 6—38 % of patients with pulmonary tuberculosis (TB). From 16 to 46 % of patients with tuberculosis infection have concomitant signs of diabetes mellitus (DM). In 58.9 % of patients with sensitive TB, the absorption capacity of the small intestine significantly decreases, with a predominant decrease in the intestinal permeability index from 3.1 to 6 (in 21.9 % of cases). In MDRTB, a decrease in the absorptive function of the intestine is observed in 76.1 % of cases with a predominance of a severe degree of impairment (in 42.3 % of patients). The specific gravity of severe forms among cases of sensitive TB is more than 42 %, of which (69.6 ± 1.6) % were diagnosed as destructive. The share of common forms of TB among all cases of chemoresistant TB (XDRTB), which are treated in category 4 is 47 % of cases, of them with destructive forms — (78.5 ± 3.6) % of cases. The incidence of adverse reactions increases with severe forms of XDRTD and is 38 % of all analyzed cases. Conclusions. Additional measures are needed to increase the effectiveness of management of severe forms of tuberculosis and in the presence of concomitant pathology, namely, the early identification of patients with severe forms and their isolation into a separate category of «severe TB patients» and the introduction of individual approaches to treatment with intensification of therapy, especially in the early stages treatment (during the intensive phase, which is the most critical period) with the use of injection forms of antimycobacterial drugs.
Authors and Affiliations
L. D. Todoriko, V. I. Petrenko, O. S. Denіsov, I. O. Semіaniv, T. A. Sprynsіan, O. V. Pidverbetska
Keywords
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