Improved detection of tuberculosis in primary health care and its impact on the incidence

Abstract

The objective of the study: to determine the potential improvement of tuberculosis detection in primary health care institutions ( PHC ) through identification of risk groups and screening them for tuberculosis. Subjects and methods. Tuberculosis incidence in Azerbaijan over 10 years (200 6-2 015) was retrospectively analyzed. In two districts of Baku (with TB incidence rate of ≤ 30 per 100,000 population), certain activities were performed to confirm that such level of tuberculosis incidence among the local population was tru e-to-l ife. The groups of the population with the highest tuberculosis detection rate were identified. In 2016, those groups included: pensioners, housewives, i n-c ountry migrants, e x-p risoners, as well as people at the age group 1 9-2 4 years old. In 2016, a central register for these groups was created that helped to screen them for tuberculosis in 201 7-2 018. Results. The problems interfering with tuberculosis detection in PHC were identified. In this regard, in two districts of Baku with TB incidence ≤ 30, health education among medical personnel and population was intensified, social groups facing the high risk to develop tuberculosis were identified, and laboratory diagnostics of tuberculous mycobacteria tuberculosis ( MTB ) was improved. For the first time in PHC , the rapid molecular genetic method (GeneXpert MB T /R if) was used to detect MTB DNA and the predictor of multiple drug resistance. As a result of the events of 201 7-2 018 aimed to screen risk groups for tuberculosis, the incidence in those two districts among the local population increased by 1.5 times, and in the overall population of both districts – by 1.7 times. After that, the clinical structure of new tuberculosis cases improved. Thus, the rate of focal tuberculosis increased by 3 times. Among extrapulmonary tuberculosis cases, there were no cases of meningitis.