Lecture subject:

“ORGANIZATION OF

TUBERCULOSIS CARE FOR

CHILDREN AND TEENAGERS IN THE

RUSSIAN FEDERATION”

Lecturer: professor,

Dr. habil. med. BABAEVA I.YU.

THE STRUCTURE OF TB DISPENSARY INCLUDES

THE FOLLOWING DEPARTMENTS:

•Dispensary and polyclinic departments for adults and children.

•Laboratory department.

•X-ray department.

•Bacteriological department.

•Bronchology department.

•Department of extrapulmonary tuberculosis.

•Organizational and methodological department.

•Housekeeping department.

MAIN TASKS OF THE TB DISPENSARY:

1. Organization and implementation of activities for the prevention of tuberculosis.

2.Organization and implementation of measures to detect tuberculosis.

3.Treatment of tuberculosis.

4.Dispensary observation of registered contingents.

TUBERCULOSIS PREVENTION

1.Systematic analysis of the TB epidemiological

situation and the effectiveness of anti-TB measures in the dispensary service area.

2.Planning of BCG vaccination and revaccination together with maternity hospitals, children's clinics, Center for State Sanitary and Epidemiological Surveillance (CSSES).

3.Hospitalization of bacterial excretors in hospitals; isolation of newborns from bacterial excretors for the period of formation of post-vaccination immunity.

TUBERCULOSIS PREVENTION

4.Implementation of preventive measures in relation to persons who are in family contact with bacterial excretors: regular dispensary observation of them, carrying out preventive measures in the focus of tuberculosis infection, sending children to children’s sanatoriums.

5.Participation in the improvement of workplaces of sick bacteria excretors at enterprises.

6.Carrying out, together with the Center for State Sanitary and Epidemiological Surveillance and organizations of the veterinary system, measures to prevent TB in livestock and poultry workers with the formation of “threatened” contingents from among farm workers, dispensary monitoring of them and conducting health- improving measures and chemoprophylaxis for them.

TUBERCULOSIS DETECTION

1.Together with the Center for State Sanitary and Epidemiological Surveillance, medical and preventive institutions of the general medical network, planning and monitoring examinations using the method of fluorography and tuberculin diagnostics.

2.Assistance in the formation of risk groups for tuberculosis in polyclinics.

3.Consultations by phthisiatricians of patients who are in other medical institutions.

4.Examination of persons referred to the dispensary with suspected tuberculosis.

TUBERCULOSIS TREATMENT

1. Hospitalization of patients in hospitals, organization of their treatment on an outpatient basis in a controlled way, sending them to sanatoriums.

2.Conducting an examination of working capacity and referral to Disability Determination Services (DDS).

3.Carrying out activities for the comprehensive social rehabilitation of patients with tuberculosis.

DISPENSARY OBSERVATION

1.Registration and regular monitoring of dispensary contingents.

2.Conducting classes for the training of medical personnel on tuberculosis.

3.Collection and analysis of materials on the epidemiology of TB in the district, region; on their basis, presents for discussion by scientific societies and associations, congresses, conferences, meetings of phthisiatricians and doctors of other specialties issues of prevention, diagnosis, TB treatment and organization of TB control.

4.Promotion of best practices in TB control.

5.Sanitary and educational work.

TB DETECTION IN CHILDREN

AND TEENAGERS

A distinctive feature of TB in children is the involvement of the entire lymphatic system, mainly intrathoracic lymph nodes, in the pathological process, and the slow evolution of specific changes in them.

The localization of the pathogen in the lymphatic system is one of the reasons limiting the possibility of bacteriological confirmation of the diagnosis (at least 90% of children and 50% of adolescents with newly diagnosed TB of the lungs and intrathoracic lymph nodes are not bacterioexcretory).

TB DETECTION IN CHILDREN

AND TEENAGERS

In these cases, the TB diagnostics is based on combination of the data obtained from:

1.anamnesis;

2.results of tuberculin diagnostics;

3.clinical and radiological data;

4.laboratory test results.