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Burden of major Respiratory Diseases WHO Survey Ryazan region of Russia,. RUSSIA. Ryazan region of Russia, health care system :. 104 hospitals district hospitals – 32 rural hospitals – 44 65 out-patient departments 792 “ feldsher's ” station s.
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Burden of major Respiratory DiseasesWHO Survey Ryazan region of Russia,
Ryazan region of Russia, health care system: • 104 hospitalsdistrict hospitals – 32 rural hospitals – 44 • 65 out-patient departments • 792“feldsher's” stations
Total area- 39600 square kilometres. Density of population– 32 per square kilometre. • Total population • 1 mlln. 230 thousand people,600 000 live in Ryazan. • 96% - Russians. • Rural population • – 31%. Shilovo district Population – 60 000. Scopin district Population – 40 000.
Protocol for assessment of prevalence of major respiratory diseases Number of patients Clinical survey and lung function test Prevalence survey of respiratory diseasein a household manner Prevalence survey of respiratory disease at the PHC level Pilot stage October 2004 March 2006
Pilot stage 05.10.04-15.10.04 • Obtaining the list of PHC • Finalize the questionnaires and the GP’s, RT’s and LFT forms • Training of the personnel • Design, plan and execute pilot prevalence survey • Determine whether the “cookbook” • (protocol & manual of procedures) works • Test communications
Prevalence survey of respiratory disease in a household manner 22.11.04-28.12.04 • Population: Individuals >= 5 years randomly selected • Administered standardised questionnaire on symptoms, diseases, diagnoses, comorbidity, sociodemographics, risk factors
Clinical survey and lung function test 08.02.05-30.03.05 16 PHS were randomized for the lung function test. All patients from the household stage were included.
Clinical survey and lung function test 08.02.05-30.03.05 16 PHS were randomized for the lung function test. All patients from the household stage were included.
Age distribution of risk factors, by stages (self-reported by patients)
Age distribution of symptomatic respiratory patients, by stages (self-reported by patients)
Age distribution of symptomatic respiratory patients, by stages (self-reported by patients)
Age distribution of symptomatic respiratory patients, by stages (self-reported by patients)
Age distribution of symptomatic respiratory patients, by stages (self-reported by patients)
Bronchial obstruction and smoking Pack-years, mean Bronchial obstruction degree
Bronchial obstruction and dyspnea Part of patients with dyspnea Bronchial obstruction degree
Treatment Only 2 from 100 patients with respiratory symptoms and low pulmonary functionregularly use inhalation of bronchodilators
Treatment Among the patients with bronchial asthma: • regularly use inhalation of glucocorticoids – less than 1% • regularly use inhalation of bronchodilators – 1,5% • regularly use theophylline – 15 %
“Adequate education, should be available,in order to ensure correct diagnosis and treatment, in particular in primary care.”
Educational programKey stones • Optimization of prophylactic programs for primary care settings to reduce risk factors • Diagnostic algorithm for primary care settings based on the main symptoms and risk factors • Using spirometry like routine method in primary care • Optimization of rehabilitation program for primary care settings to reduce patients disability
Comparison of age distribution, in years, by stages between sexes
Prevalence of respiratory diseases, by stages (self-reported by patients)
Main symptoms and medical diagnosis of chronic bronchitis Cough Wheezing Phlegm Dyspnea Part of patients with symptoms Patients without established diagnosis Patients with established diagnosis
Heat or cookusing an open fire Risk factors and chronic cough Work in any dusty job Smoke Part of patients with risk factors Patients without chronic cough Patients with chronic cough
Heat or cookusing an open fire Risk factors and phlegm production Work in any dusty job Smoke Part of patients with risk factors Patients without phlegm Patients with phlegm
Heat or cookusing an open fire Risk factors and wheezing Work in any dusty job Smoke Part of patients with risk factors Patients without wheezing Patients with wheezing
Heat or cookusing an open fire Risk factors and dyspnea Work in any dusty job Smoke Part of patients with risk factors Patients without dyspnea Patients with dyspnea
Heat or cookusing an open fire Risk factors and medical diagnosis of chronic bronchitis Work in any dusty job Smoke Part of patients with risk factors Patients without with established diagnosis Patients with with established diagnosis
Bronchial obstruction and risk factors Part of patients with risk factors Bronchial obstruction degree
Bronchial obstruction and medical diagnosis of chronic bronchitis Part of patients with established diagnosis Bronchial obstruction degree
Bronchial obstruction and chronic cough Part of patients with chronic cough Bronchial obstruction degree
Bronchial obstruction and chronic phlegm productin Part of patients with phlegm production Bronchial obstruction degree
Bronchial obstruction and weezing Part of patients with wheezing Bronchial obstruction degree
Pilot stage 05.10.04-15.10.04 • Obtaining the list of PHC • Finalize the questionnaires and the GP’s, RT’s and LFT forms • Training of the personnel • Design, plan and execute pilot prevalence survey • Determine whether the “cookbook” • (protocol & manual of procedures) works • Test communications
Prevalence survey of respiratory disease in a household manner 22.11.04-28.12.04 • Population: Individuals >= 5 years randomly selected • Administered standardised questionnaire on symptoms, diseases, diagnoses, comorbidity, sociodemographics, risk factors
Prevalence survey of respiratory disease at the PHC level18.10.04-20.11.04 • Population: Individuals >= 5 years attending PHC • Administered standardised questionnaire on symptoms, diseases, diagnoses, comorbidity, sociodemographics, risk factors