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Diagnostic algorithms of TB case finding and their effect on TB epidemiology in Russian Regions

Diagnostic algorithms of TB case finding and their effect on TB epidemiology in Russian Regions. Andrey Maryandyshev, Elena Nikishova Northern State Medical University Arkhangelsk, Russia. Arkhangelsk region of the Russian Federation. Area: 578 ,000 square km Population: 1, 117, 096

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Diagnostic algorithms of TB case finding and their effect on TB epidemiology in Russian Regions

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  1. Diagnostic algorithms of TB case finding and their effect on TB epidemiology in Russian Regions Andrey Maryandyshev, Elena Nikishova Northern State Medical University Arkhangelsk, Russia

  2. Arkhangelsk region of the Russian Federation • Area: 578,000 square km • Population: • 1, 117, 096 • people • 24 municipal districts • 11282 in penal system

  3. TB service of the area 27 municipal tuberculosis ambulatory Arkhangelsk Clinical Antituberculosis Dispensary reference laboratory and 3 in-patient departments for 100 patients: Sensitive TB SS+ 35 MDR/XDR TB SS+ 35 Sensitive, MDR TB SS- 30 Out-patients department Regional hospital of penitentiary system - bacteriological laboratory and 2 in-patient departments for 140 patients (sensitive and MDR) TB Colony for continuation treatment

  4. TB Incidence including penitentiary system(new cases and relapses ) and mortality in Arkhangelsk Region 2001-2012(per 100 000 population)

  5. MDR TB burden among new cases and relapses consist 35,4% in 2013

  6. Rapid Drug Susceptibility Tests implemented • BacTAlert– 2004-2009 • LPA (Hain Test)in 2009 –DST for 1 and 2 line drugs • Bactec MGIT - DST for first line drugs -2010 DST for second line drugs - 2011 • Gene Xpert - 2011

  7. Algorithm in Arkhangelsk region

  8. TB registration in the civil sector of Arkhangelsk region, 2007 – 2013

  9. DST results of new TB cases

  10. DST results of patients with relapse of TB

  11. DST results of patients with category “treatment after loss to follow-up”

  12. DST results of patients with category “treatment after failure”

  13. Standard regimens for treated all TB patients depending of the DST

  14. Treatment outcomes of patients with sensitive TB

  15. Treatment outcomes of patients with H resistance.

  16. MDR-TB treatment outcomes

  17. Results of treatment of TB with resistance to R/ HR

  18. Treatment outcomes of clinical cases of MDR-TB.

  19. Treatment results of patients without MTB confirmation (Radiology confirmation)

  20. Treatment outcomes of Sm (+) patients with no DST data.

  21. Results of treatment all registered (508) TB cases in civil sector in 2012 Treatment success (preliminary data) • New cases– 67,4% (279/414), 11,1% (46/414) – treatment continue • Relapses ––52,4% (43/82), 13,4% (11/82) – treatment continue • «treatment loss follow up» –– 57,1% (4/7) • «failure treatment»–60,0% (3/5) • Among all registered cases in 2012– treatment success 64,8% (329/508), 13,8%- (57/414) – treatment continue

  22. Conclusion • Everyone tuberculosis patient before of treatment should have the Rapid Drug Susceptible Test • WHO Standards of treatment according DST cured more than 80 % tuberculosis patients

  23. Thank you for attention!

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