QUALITY GRADE OF HEALTH CARE FOR TUBERCULOSIS WHEN JUXTAPOSED TO FEDERAL PROGRAM ENDPOINTS
The Federal Program: Prevention and combatting socially sensitive conditions in 2007-11, subprogram: tuberculosis -had put forward the endpoints (by 2011) of TB-bacillus-free proportion in the pool of TB patients as 41.6% and of TB-caused mortality as 17.8 cases upon 100.000 of the population. Now these two endpoints have been surpassed reaching 35.9% and 14.2 cases, accordingly. There exists an opinion, however, that these endpoints of the subprogram had been down-graded from the very beginning simply on the premise that in reality they were reached in 1-2 years after the launch of this Program. Results of the study: The analysis of real situation with tuberculosis in Russia showed that: The ratio of TB incidence produced by legally free population to that of the cohort of prisoners and convicts has become quite stable at the level fixed in 2011 as 83.8%: 11.3% Many epidemiologic features in the cohort of prisoners and convicts factually mimicked the situation in legally free population More advanced rates of reducing TB-caused mortality than in reducing incidence rates were identified as potentially favorable tendency. Incidence: mortality ratio has raised in 2005-11 from 3.7 to 5.7 in the overall population; from 3.2 to 4.4 in males, from 6.2 to 8.1 in females; from 3.8 to 5.3 in the urban and from 3.5 to 4.9 in the rural population. Conclusion: epidemic situation in Russia has moved towards certain stabilization, the counter-factors still persisting, were: 1. advancements in HIV-infection in Russia, as the situation with HIV-infection obviously tends to contribute more and more to the incidence and prevalence of tuberculosis; 2. epidemiologic growth of multiple drugs resistance (MDR) of TB mycobacteria to anti-TB preparations. MRN in TB could readily infringe on the treatment efficiency and thus could prospectively lead to increased mortality.