Tuberculosis in Tajikistan
Epidemiological and Epizootical Features and Organization of Sanitary and Epidemiological Surveillance of Tuberculosis in Tajikistan
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine AGR-DIS/Disease Surveillance/Agriculture
3 Approved without Funding
Tajik State Medical University, Tajikistan, Dushanbe
- City Disinfection Station, Tajikistan, Dushanbe\nRepublican Center for Tuberculosis, Tajikistan, Dushanbe
- Walter Reed Army Institute of Research / Biothreat Group: Aerobiology and Animal Modeling, USA, MD, Silver Spring
Project summaryTuberculosis is an infectious disease, chronically proceeded diseases, common for all types of animal and human.
Causative agent is Mycobacterium, which includes more then 30 separate types. Pathology condition in animal caused by M. bovis, M. tuberculosis in human, in bird – M.avium. M.bovis more pathogenic for cattle and other mammary, including human. M.tuberculosis – human, domestic animals (cats, dogs) and other livestock (cattle, small livestock and pigs,) M.avium – domestic and wild bird and pigs.
Epidemiological situation on tuberculosis declines everywhere and every year about 2 million people die. It is presumed that in the nearest years more then 20 million people can be infected by this agent and mortality will increase up to 70 million.
Situation in Tajikistan starting from 1991 was dramatized by civil war, disasters and migration, social-economical crisis, decreasing quality of environment. Currently Tajikistan is in the list of 20 poorest countries in the world and index of human potential development 112 out of 174 surveyed countries. Deterioration of an economic situation has reached a level when poverty became the reason of growth of morbidity and mortality rates. Accordingly the above-named reasons financing public health services with 192 up to 1¯5 dollar per capita was progressively reduced. Health system id facing shortage of human resources, and there is a need for 3000 doctors and 3500 paramedical staff.
The increase in tuberculosis prevalence also is caused by growth of number socially desadapted groups of the population and a contingent of prisoners in establishments peniciar systems. All this is connected by that tuberculosis is sharply directed social illness.
According to the official statistic morbidity indicators in the last five years increased from 44.9 to 55.6 per 100. However, recording data are not reliable and less which was confirmed by Multi Indicator Cluster Survey (MICS) data.
In Tajikistan more then 80% of patients with destructive forms of TB, including 90% of them according to the appeal ability. Up to 80 % of patients have multi resistant forms of activators; each of them can infect 10-12 people in a year.
Therefore for studying biological features of the activator and circulation multi resistant forms of Tuberculosis at early stages, it is necessary to approbate and introduce of complex methods of identification and diagnostics of Tuberculosis at early stages including multi resistant forms that have great value for decrease in mortality and morbidity rates.
The tuberculosis has ceased to be illness of vagabonds, addicts, alcoholics and prisoners, it a thicket began to hurt quite safe and richer population.
In this connection problem Tuberculosis is the one of the sharpest in the country. In comparison about 1996 parameter of disease in 2002 has grown more than in 2 times and has made 67.3 per 100 000 population, at parameters of death rate 9.7. Indirect data testify too much greater prevalence of Tuberculosis (127.3) and the forecast for nearest future is increasing in the next 5 years 160.0 per 100 000 population.
It is observed numerous cases of repeated Tuberculosis diseases at clinically cured persons. Relative density and the importance of risk factors not similar in various regions. Growth of number of Tuberculosis cases is promoted by decrease in the immunity, an insufficient feed, a HIV - infection, a diabetes, to illness of a stomach and iodine deficit conditions, including women of reproductive age, especially in a countryside where lives 76 % of the population of the country. Tuberculosis endemic has left from under the control of bodies of public health services and in at of veterinary system practices.