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7/29/2019 TB Sem 1 Lecture
1/81
1843-1910
1882.
1890. 1905.
och R. Die Aetiologie der Tuberculose.
Berl.Klin.Wschr., 1882; 15: 221-230.
7/29/2019 TB Sem 1 Lecture
2/81
1.
2.
3.
7/29/2019 TB Sem 1 Lecture
3/81
7/29/2019 TB Sem 1 Lecture
4/81
1888-1973
1943 .
1952 .
7/29/2019 TB Sem 1 Lecture
5/81
Mycobacterium tuberculosis 85-90%
Mycobacterium bovis 10-15%
Mycobacterium avium 3%
7/29/2019 TB Sem 1 Lecture
6/81
Mycobacterium tuberculosis
complex
M.tuberculosis
M.bovis
M.africanum M.microti
M. canettii,
M. pinnipedii
M. caprae
7/29/2019 TB Sem 1 Lecture
7/81
7/29/2019 TB Sem 1 Lecture
8/81
7/29/2019 TB Sem 1 Lecture
9/81
1,5 .2-3 .
5 . 25 .
7/29/2019 TB Sem 1 Lecture
10/81
90-95%
7/29/2019 TB Sem 1 Lecture
11/81
7/29/2019 TB Sem 1 Lecture
12/81
7/29/2019 TB Sem 1 Lecture
13/81
-1
-
7/29/2019 TB Sem 1 Lecture
14/81
7/29/2019 TB Sem 1 Lecture
15/81
7/29/2019 TB Sem 1 Lecture
16/81
-
7/29/2019 TB Sem 1 Lecture
17/81
7/29/2019 TB Sem 1 Lecture
18/81
.:
7/29/2019 TB Sem 1 Lecture
19/81
7/29/2019 TB Sem 1 Lecture
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, ,
( 65 )
7/29/2019 TB Sem 1 Lecture
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,)
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,
7/29/2019 TB Sem 1 Lecture
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,
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7/29/2019 TB Sem 1 Lecture
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,
. , ,
.
7/29/2019 TB Sem 1 Lecture
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, ,
.
..
.
7/29/2019 TB Sem 1 Lecture
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.2001 .
7/29/2019 TB Sem 1 Lecture
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.2001 .
Wells W.E. On air-bome infection. Stady II.Droplets and droplet nuclei. Am.J.Hyg., 1934;
20:611-8 , .
1 = 5 . =>
50% 30
.
7/29/2019 TB Sem 1 Lecture
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.2001 .
, , , ,
\ .
7/29/2019 TB Sem 1 Lecture
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Accuracy, ,
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Age-specific rate
. Case (, ). /
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7/29/2019 TB Sem 1 Lecture
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Evidence - . Incidence,
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. ... 100 .
7/29/2019 TB Sem 1 Lecture
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2 .
7/29/2019 TB Sem 1 Lecture
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100000
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7/29/2019 TB Sem 1 Lecture
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100000
,
7/29/2019 TB Sem 1 Lecture
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(2009 .\2010 .)
86,2 \77,4 100.
185,1\178,7 100.
16,5\15,4 100 .
.
-
; 2010.
7/29/2019 TB Sem 1 Lecture
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141, 9 .
. 2 858 .
- 4 736 .
11,6 .
2010 .
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2010 .\2011 . 45,5\ 40,8 100 .
( 27,6\ 24,2 100.)
68,7\ 58,6 100. (25,8\ 20,6 100 .)
5,6\ 4,2 100 .( - 3,1 \ 2,6 100.)
.
7/29/2019 TB Sem 1 Lecture
36/81
-
(2010 .)
:
- 15,2 100 .*
:
- 36,3 100 .
(2011 .)
:
22,0 100 .
:
27,5 100 .
*
7/29/2019 TB Sem 1 Lecture
37/81
2011 .( . ) : 47,3%
:
18,7%
: 7,3%
:8,0%
207
.
7/29/2019 TB Sem 1 Lecture
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7/29/2019 TB Sem 1 Lecture
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-
50-78% .
7/29/2019 TB Sem 1 Lecture
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7/29/2019 TB Sem 1 Lecture
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- ,
, ,
.
.
7/29/2019 TB Sem 1 Lecture
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- .
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7/29/2019 TB Sem 1 Lecture
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2007 .
327899-
, 2008 . 440000
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,
.
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7/29/2019 TB Sem 1 Lecture
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: 7992 ( 2%
), 170 1488, ( 200)
107 ( 133)
, - ,
- 14081
7/29/2019 TB Sem 1 Lecture
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- 30 40%
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60 70%
7/29/2019 TB Sem 1 Lecture
46/81
,
,,
,
7/29/2019 TB Sem 1 Lecture
47/81
:
(MDR multidrug resistance)
H R.( , extensive drug resistance) H R
(, , )
7/29/2019 TB Sem 1 Lecture
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:
,, , .
, .
7/29/2019 TB Sem 1 Lecture
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, 2010.:
\ 2010 . .33 30,3%.
( 7-) - 34,7%.
7/29/2019 TB Sem 1 Lecture
50/81
2008 2009 .
65.8
36.8
86.8
21.1 23.7
7.9 7.9
36.8
76.9
56.4
85.7
28.2
23.4
7.9 6.5
56.4
0
10
20
30
40
50
60
70
80
90
100
H R S E K Pt Fn (H+R)
- 2008 - 2009
7/29/2019 TB Sem 1 Lecture
51/81
.
(% )
185264 292
382
805
1393
2481
2001 2002 2003 2004 2005 2006 2007
7/29/2019 TB Sem 1 Lecture
52/81
7/29/2019 TB Sem 1 Lecture
53/81
(%%
)
3528
2777
2099
1590
1336
939
1750
2001 2002 2003 2004 2005 2006 2007
7/29/2019 TB Sem 1 Lecture
54/81
,. (.)
18
32
18
16
12
2003 2004 2005 2006 2007
:
2003 0,02 %
2004 - 0,05 %
2005 - 0,02 %
2006 0,02%
2007 0,01%
7/29/2019 TB Sem 1 Lecture
55/81
, .
(.)
7
10
10
7
20
1
43
10
0
5 66
0
3
1 3
7
0
2
0
2003 2004 2005 2006 2007
7/29/2019 TB Sem 1 Lecture
56/81
.
8413
1671
1563
9074
1446
1682
8634
1346
1614
9277
1347
1585
8258
917
1270
8860
948
1330
0
1000
20003000
4000
5000
6000
7000
8000
9000
10000
2002 2003 2004 2005 2006 2007
1- 1- 1-
7/29/2019 TB Sem 1 Lecture
57/81
185
48295292
1443815192
12552 12687 1253812967
158180174279 267
288464 436 436 281
215
42733743 3746 3800
0
2000
4000
6000
8000
1000012000
14000
16000
2002 2003 2004 2005 2006 2007
1 2 3 1
,
7/29/2019 TB Sem 1 Lecture
58/81
, (2004 )
42%
30%4%
2%
22%
7/29/2019 TB Sem 1 Lecture
59/81
49%51%
7/29/2019 TB Sem 1 Lecture
60/81
2006
..
2005
7/29/2019 TB Sem 1 Lecture
61/81
-
:
2005 . 2004. 6,4 %;
;
10,5 % ;
8,8 %;
9,7 %;
9,6 %.
.
7/29/2019 TB Sem 1 Lecture
62/81
(1992-2006 .)
83,
8
83,
1
35,
842,
948,
0 57,
9 67
,5
74,
0
76,
1 85,
490,
4
88,
5
86,
1
83,
2
83,
1
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
100.
7/29/2019 TB Sem 1 Lecture
63/81
2006 .
0,8%,
1,3%,
5,6%.
7/29/2019 TB Sem 1 Lecture
64/81
7/29/2019 TB Sem 1 Lecture
65/81
. . 1998-2006
68,
4
67,
7
67,
5
65,
8
66,
2
65,
6
64,
7
59,
8
56,
5
1998 1999 2000 2001 2002 2003 2004 2005 2006
.
7/29/2019 TB Sem 1 Lecture
66/81
(2006 )
0,8%(0,9 .)
12,1%(14,3 .)
87,1%(102,0 .)
7/29/2019 TB Sem 1 Lecture
67/81
56-
; 37-
-
; 41,6%
, 9,4%
; 5-
.
(%) 2006
7/29/2019 TB Sem 1 Lecture
68/81
(%). 2006 . .
26,00%
20,60%
20,20%
8,30% 13,70%
6,20% 2,90% 2,10%
0-14 15-17 18-24 25-34
35-44 45-54 55-64 > 65
7/29/2019 TB Sem 1 Lecture
69/81
(%) 2006
7/29/2019 TB Sem 1 Lecture
70/81
(%) 2006 . .
26,20%
16,70%
8,20%
6,60%
15,70%
17,80%
4,80%3,60%
0-14 15-17 18-24 25-34
35-44 45-54 55-64 > 65
. (1992 2006 )
7/29/2019 TB Sem 1 Lecture
71/81
(1992-2006 .)
16,
4
16,
4
16,
1
1
6,
0
16,
219,
1
17,
8
17,
9
1
5,
8
14
,7
9,
4
10,
5
12,
0
13,
1
13,
2
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
100.
2006
7/29/2019 TB Sem 1 Lecture
72/81
. . 2006 .
77,0
143,2
119,1
104,9
75,0
36,6
15-24 25-34 35-44 45-54 55-64 65
,
7/29/2019 TB Sem 1 Lecture
73/81
(1992-2006 .)
11,
41
4,2
16
18
18,
4
1
6,
5
16,
8
17,
7
18,
2
18,
5
18,
5
18,
4
19,
4
22,
7
20,
9
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
1998 2006
7/29/2019 TB Sem 1 Lecture
74/81
. . 1998-2006 .
2
34,
8
246,
6
263,
4
270,
2
272,
8
264,
8
21
9,
4
209
,8
204
,1
1998 1999 2000 2001 2002 2003 2004 2005 2006
7/29/2019 TB Sem 1 Lecture
75/81
(%)
7/29/2019 TB Sem 1 Lecture
76/81
(%)
18,20%
0,10%
36,90%
25,50%
19,30%
I-II III IV V VI
7/29/2019 TB Sem 1 Lecture
77/81
2006
386( 2005 466) .
332 ( 2005 393).
.
2006 . 55219 ,2005. 55976
86% :
7/29/2019 TB Sem 1 Lecture
78/81
:
59%
100
28% 101
300
13%
301
7/29/2019 TB Sem 1 Lecture
79/81
(2007-2011 .)
: (8%)
(34,4%)
-/ (11,4%)
(16,2%)
, (5%)
(8,6%) !!!
(10%) !!! (3,9%)
(2,5%)!!!
2007 2011
7/29/2019 TB Sem 1 Lecture
80/81
2007-2011 .
:
45,9 %
52,4%
1,7%
76 393,5.
2007 2011
7/29/2019 TB Sem 1 Lecture
81/81
2007-2011 .
26300,0. . :
62,80%
37 20%
19,80%
0,60%
79,60%