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Tuberculosis
in Ukraine
Picture Source
Signs and Symptoms
-Productive, prolonged
cough of more than three weeks
-Chest pain
-Hemoptysis
-Systemic symptoms
---Fever
---Appetite/weight loss
---Easy fatigability
Extrapulmonary TB
Picture:
All the places where one can get TB
Source
25% of tuberculosis
cases and can accompany pulmonary TB
-CNS (meningitis)
-Lymphatic system
(scrofula of the neck, not contagious)
-Genitourinary system
-Bones
-Joints (Pott’s
disease)
-Miliary TB (common in
HIV patients, and is especially serious)
Pathogenesis
-Inhalation of bacilli
-Bacilli trapped by
immune system
-Bacilli sealed up in
hard nodular tubercles (cheese-like mass
that breaks down the respiratory tissues and
forms cavities in the lungs)
Picture:
Representative plate of tubercles and scar
tissue in lung
Source
-Scar tissue can
eventually replace the nodules upon
treatment
-However, once in the
blood (which can happen when tubercles break
down and release bacilli), TB can travel
almost anywhere in the body
-Death can result from
failure of ventilation and general toxemia
or exhaustion
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TB Statistics
Picture:
Ukrainian People
Source
*48,000 new cases annually
*Incidence ~ 100/100,000 people
*Mortality ~ 15/100,000 people
*8.3% of TB cases that are HIV
+
*10% of new cases are MDR-TB
No current 'directly observed
therapy, short course' (DOTS) data found
Ukrainian Prisons
Higher risk for developing
active TB due to the following problems:
-Poor infection control
-Delays in diagnosis
-Inadequate treatment
-High prevalence of HIV
Picture:
Ukrainian Prison
Source
-Overcrowding and poor
nutrition
TB is not unavoidable in
prisons! DOTS can be implemented to help control the
spread of TB. Effective TB control benefits others
besides the prisoners. It helps to protect staff,
visitors, and the community at large as well. There
are currently programs in the Ukraine designed for
prison managers to train/enable them to help control
TB in their prison.
Ukraine and XDR-TB
Progression of MDR-TB
-It has been said that treating
MDR-TB is like treating cancer, and XDR-TB is even
worse
Picture:
Ukrainian Flag
Source
Highest Concentration is in
Western Europe/Asia
-69,000 people have died from
TB with an estimated 450,000 new cases in 2004 in
the
WHO European Region
WHO organizing a Ministerial
Forum in 2007
-Goals of forum include
increasing funding to the European Union
Prevention and Control
Strategies
~Four main priorities~
1) Identify and treat all those
who have TB
2) Find and evaluate those that
have been in contact with people with TB (and treat
them appropriately)
3) Test high-risk groups for
latent TB and treat before onset of active TB
4) Maintain surveillance
standards (which allows for the tracking of
progress)
Picture:
STOP TB Logo
Source
-Save an additional 14 million
lives between 2006-2015
Components of partnership
-DOTS expansions (the major
plank of the program)
-Control MDR-TB
-Address high risk groups
-Engage all care providers
-Empower those with TB
-Promote TB Research
Ukraine in the News
Ukraine’s Cabinet of Ministers
approves plan for national TB program (6-27-06)
Ukraine Health Ministry to
establish a group working on TB and HIV Project
Grant (6-6-06)
Ukraine Adopts Resolution to
Establish TB, HIV/AIDS Committee (6-2-06)
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