ФАКТОРЫ РИСКА РАЗВИТИЯ ТУБЕРКУЛЁЗА В ПЕНИТЕНЦИАРНЫХ УСЛОВИЯХ

Abstract

Objective: To establish risk factors of the development of penitentiary tuberculosis in conditions of stabilization of the epidemic situation. Methods: 1463 patients with various forms and clinical cure for tuberculosis were observed in penitentiary institutions. Standard methods for diagnosis and treatment of tuberculosis, including psychometric examination, as well as new pathogen detection tools, such as Xpert® MTB/RIF, BAK-TEK-960 systems, and DikskinT are used for tuberculin diagnostics. Results: The effectiveness of anti-epidemic measures is established integrated with the administration of penitentiary institutions. The contingent of HIV-infected people becomes one of the main risk groups and sharply increases, while up to 30% of dispensary contingents are "diagnostic" socially maladaptive individuals who were examined to verify the etiology and activity of the process. The importance of socially-determined risk factors has been confirmed, however the leading importance is the state of clinical cure, staying in contact and in extreme conditions and concomitant diseases. First setting individual psycho-functional states (as a state of aggression and embitterment) is established in the development of penitentiary tuberculosis or its recurrence. The risk of tuberculosis is increased by 1.3 times in the presence of concomitant diseases, and the probability of occurrence of active tuberculosis in persons suffering from various concomitant pathologies is 1.7 times higher in those in extreme conditions than in healthy people in similar conditions. At simultaneous influence of such factors, the risk of the disease rises by four, and together with relapses (active tuberculosis) – almost seven times. Conclusion: Recommended developing targeted measures to prevent the spread of the infection in penitentiary institutions, taking into account risk factors. Keywords: Tuberculosis, penitentiary institutions, risk factors.