bavSvTa tuberkulozi

kilimanjaros regionSi

“samSabaToba”; maia SarifaSvili; 13.07.10

TB globaluri problema

mTels msoflioSi tuberkulozi infeqciur daavadebaTa Soris umTavres problemad rCeba;

weliwadSi fiqsirdeba tuberkuloziT daavadebis 9 milioni SemTxveva; gardacvalebis 2 milioni SemTxveva; bolo wlebSi TB tvirTis zrda

ganpirobebulia HIV/AIDS pandemiiT; TB pacientTa saerTo ricxvis 11%-s 15

wlamde asakobrivi jgufis bavSvTa tuberkulozis SemTxvevebi Seadgenen;

bavSvTa TB-is yvelaze maRali maCvenebeli afrikis dabali da saSualo Semosavlis mqone qveynebze modis;

warsulSi TB nacionaluri programebi upiratesad mozrdilTa TB problemis gadaWraze muSaobdnen;

bavSvTa TB-isadmi programuli midgoma arasakmarisad aqcentirebuli iyo;

uaxles TB kvlevebSi mniSvnelovani adgili daikava bavSvTa TB-m;

kilimanjaros regionis 2002–2006 wlis monacemebi:

15 wlamde asakis bavSvebSi registrirebuli iyo 1615 TB SemTxveva, rac TB saerTo maCveneblis 13%-s Seadgenda;

bavSvTa TB insidentobis saerTo maCvenebeli: qalaqis mosaxleobaSi iyo 147/100 000 mosaxleze; soflis mosaxleobaSi - 41.8/100 000 mosaxleze; fitlvis formaze modioda bavSvTa TB SemTxvevaTa

75.2%, filtvgareSe formaze bavSvTa TB SemTxvevaTa – 24.8%;

mkurnalobis warmatebuli gamosavali dafiqsirda SemTxvevaTa 79.9%-Si;

mkurnaloba Sewyvita 7%-ma; letaluri gamosavali dafiqsirda 10.9%-Si;

1615 SemTxvevidan naxvelis baqterioskopiuli gamokvleva Catarda 402

(29.2%) SemTxvevaSi; naxvelis nacxiT dadebiTi aRmoCnda 5.8%, nacxiT

uaryofiTi – 23.4%; letalobis yvelaze maRali maCvenebeli - 13.3% - dafiqsirda

2003 w-s; yvelaze dabali – 9.4% - 2004 w-s; mdedrobiTTan SedarebiT (73/733) sikvdilianobis

ufro maRali maCvenebeli dafiqsirda mamrobiT sqesSi (102/869);

baqterioskopiiT dadasturebul TB SemTxvevebSi sikvdilianobis maCvenebeli iyo 9.6%, daudasturebel SemTxvevebSi – 15.8%;

bavSvTa TB da HIV infeqcia

HIV maRali tvirTis miuxedavad afrikis kontinentze bavSvTa TB/HIV ko-infeqciis gamovlena arasrulyofili iyo;

1615 TB SemTxvevidan sul aiv testi Cautarda 91-s, maTgan 75 (96.3%) SemTxvevaSi dafiqsirda TB/HIV ko-infeqcia;

aiv pozitiur bavSvebSi sikvdilianoba iyo 24,2%;

ART xelmisawvdomi iyo aiv inficirebulTa mxolod 4%-saTvis;

2004 wlidan tanzaniis regionSi yvela TB pacients utardeba aiv-testi;

2005 wlidan afrikis aiv-inficirebuli bavSvTa mosaxleobisaTvis ART ufasoa, ramac Seamcira bavSvTa TB SemTxvevebis ricxvi.

bavSvTa TB da BCG vaqcinacia

kvlevam gamoavlina BCG vaqcinaciis programis arasrulyofileba - regionebis mixedviT BCG vaqcinacia arasrulyofilad tardeboda, an arasrulyofilad registrirdeboda;

kvlevis Sedegebze dayrdnobiT SemuSavda BCG vaqcinaciis programis srulyofis rekomendacia – tanzaniaSi 2002 - 2006 ww-Si BCG vaqcinaciis maCvenebeli 88%-dan 99%-mde gaizarda.

daskvna:

kvlevis Sedegad gamdidrda kilimanjaros regionSi bavSvTa TB monacemTa baza;

gamovlinda bavSvTa TB-is maRali tvirTi; diagnostikis problemebi; warumatebeli gamosavlis maRali

maCvenebeli; arasrulyofili prevenciuli midgoma - aiv-

testirebis da BCG vaqcinaciis dabali xarisxi.

tfdec-is ambulatoriuli ganyofilebis fTizio-pediatriuli samsaxuris monacemebi:

2002-2006 ww-Si gamokvleul iqna 2157 pacienti da 654 kontaqti;

TB diagnozi daudginda 236 (10.9%) pacients;

kontaqtidan avad gaxda 79 (12.1%) bavSvi; TB pacientebidan baqteriagamomyofi iyo 9

(3.8%); DR-TB dafiqsirda 3 (1.3%) pacientTan; relafsi dafiqsirda 2 (0.9%) pacientTan; generalizirebuli forma dafiqsirda 4 (1.7%)

pacientTan;

Cvens masalaze bavSvTa populaciaSi yvelaze xSirad gvxvdeba mkerdSida limfuri kvanZebis tuberkulozi - 142 (60.2%) SemTxveva;

Semdeg modis infiltraciuli tuberkulozi _ 32 (14.%) SemTxveva;

plevriti - 23 (9.7%) SemTxveva; filtvgareSe formebi – 18 (7.6%) SemTxveva; pirveladi tuberkulozuri kompleqsi – 16 (6.8%)

SemTxveva; diseminirebuli tuberkulozi – 3 (1.3%); kerovani tuberkulozi - 2 (0.85%) SemTxveva;

TBG

SemTxvevebi

sqesis mixedviT

TBG SemTxvevebi

asakis mixedviT

gogo biWi 5 w-mde 6-9 w 10-16 w

109

(46.2%)

127

(53.8%)

45

(19.1%)

58

(24.6%)

133

(56.3%)

filtvgareSe tuberkulozi N=18

Zvalsaxsris tuberkulozi 8 (44.4%)

periferiuli l/kv tuberkulozi 2 (11.1%)

mezoadeniti 4 (22.2%)

tuberkulozuri meningiti 3 (16.7%)

tuberkulozuri keratokoniuqtiviti 1 (5.55%)

avadmyofoben ufro xSirad biWebi; TiTqmis 2 jer metad avadmyofoben mozardebi (133

SemTxveva) vidre 5 wlamde asakis bavSvebi (45 SemTxveva);

rezistentuli formis tuberkulozis samive SemTxveva modis rezistentuli keridan;

relafsi ganviTarda 2 SemTxvevaSi; generalizebuli formis tuberkulozi ganviTarda 4

SemTxvevaSi; bavSvTa asakSi tuberkulozis Sorswasuli formebi sakmaod

xSiria, magram saimedoa is rom Cveni masalis safuZvelze wlebis mixedviT tuberkulozis zrdis

tendencia ar SeimCneva.

gmadlobT yuradRebisaTvis