Die Kontrolle der Tuberkulose in den Nachfolgestaaten der Sowjetunion am Beispiel Russlands

Marx, Florian M.; Skachkova, E. I.; Сон, И. М.; Стрелис, А. К.; Уразова, О. И.; Hahn, Hyewon; Krämer, Alexander; Ulrichs, Timo

doi:10.1055/s-0028-1119571

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…NSPs are widely available for PWID in Kazakhstan as well, with over 137 locations all over the country 18 . Moreover, since Kazakhstan is one of the nations affected most by the tuberculosis pandemic 55 , recently integrated approaches for TB and HIV care have been implemented, including that all patients infected with TB must be tested for HIV and vice versa 56 . Additionally, pregnant women are tested for HIV twice amid pregnancy, and there are no laws prohibiting PLWH from entering the country, while they are legally protected from discrimination 52 .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B, Hepatitis C, tuberculosis and sexually-transmitted infections among HIV positive patients in Kazakhstan

Mukhatayeva

Mustafa

Dzissyuk

et al. 2021

Sci Rep

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In contrast with global trends, HIV prevalence in Kazakhstan and other Central Asian countries has been rising in recent years. In this study, we analyzed hepatitis B (HBV), hepatitis C (HCV), tuberculosis (TB) and sexually-transmitted (STI) co-infections among 500 HIV positive study participants recruited from all regions of Kazakhstan. Among our study participants, 27%, 8%, 2%, and 5% were coinfected with, respectively, HCV, TB, HBV, and STI. A considerable proportion of the study participants was also found with triple or quadruple infections of HCV/TB (12%), TB/STI (0.8%), HCV/STI (2%), HCV/HBV (1%), HBV/TB (0.4%), HBV/STI (0.2%), HBV/HCV/TB (0.4%), HBV/HCV/STI (0.2%), or HCV/TB/STI (0.2%). Strong associations were found of certain age groups, duration of HIV infection, and practices of injection drug use and sexual contact with PLWH, with co-infections of HIV/HCV and HIV/TB. The odds of having death was 4.07 times higher with TB/HIV as compared to other co-infections. Co-occurrence of HIV with HCV, HBV, and TB infections among participants of this study highlights the necessity of regular screening for HCV infection among HIV infected patients, together with implementation of vigilant vaccination protocols against HBV and TB. Additionally, persons who inject drugs especially need to be focused for harm reduction efforts that include opiate substitution therapy, needle or syringe exchange programs, regular screening, and increased availability of ART and direct acting antivirals.

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Section: Discussionmentioning

confidence: 99%

Hepatitis B, Hepatitis C, tuberculosis and sexually-transmitted infections among HIV positive patients in Kazakhstan

Mukhatayeva

Mustafa

Dzissyuk

et al. 2021

Sci Rep

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“…While the general health sector has been and continues to be reformed in several former Soviet Republics since their independence, specialized health services, such as the TB care sector in Uzbekistan, have usually not been part of past health reforms and continue to work in the traditional way with a few exceptions [ 26 – 28 ]. Unsurprisingly, overhospitalization of TB patients has been described previously for post-Soviet states, for instance, after ambulatory DOTS programs were introduced in Russia [ 29 , 30 ] or after the Stop TB strategy was implemented in Armenia [ 31 , 32 ].…”

Section: Introductionmentioning

confidence: 94%

Health system support and health system strengthening: two key facilitators to the implementation of ambulatory tuberculosis treatment in Uzbekistan

Köhler

A³

et al. 2016

Health Econ Rev

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Uzbekistan inherited a hospital-based health system from the Soviet Union. We explore the health system-related challenges faced during the scale-up of ambulatory (outpatient) treatment for drug-susceptible and drug-resistant tuberculosis (TB) in Karakalpakstan in Uzbekistan. Semi-structured interviews were conducted with key informants of the TB services, the ministries of health and finance, and their TB control partners. Structural challenges and resource needs were both discussed as obstacles to the expansion of ambulatory TB treatment. Respondents stated need for revising the financing mechanisms of the TB services to incentivize referral to ambulatory TB treatment. An increased workload and need for transportation in ambulatory TB care were also pointed out by respondents, given the quickly rising outpatient numbers but per capita financing of outpatient care. Policy makers showed strong interest in good practice examples for financing ambulatory-based management of TB in comparable contexts and in guidance for revising the financing of the TB services in a way that strengthens ambulatory TB treatment. To facilitate changing the model of care, TB control strategies emphasizing ambulatory care in hospital-oriented health systems should anticipate health system support and strengthening needs, and provide a plan of action to resolve both. Addressing both types of needs may require not only involving TB control and health financing actors, but also increasing knowledge about viable and tested financing mechanisms that incentivize the adoption of new models of care for TB.

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“…Finally, in 1974, the WHO Expert Committee on Tuberculosis issued its ninth annual TB report, a document that established global guidelines for TB control over the next two decades. This document rejected mass radiography and tuberculin testing of the population as a successful diagnostic tool and gave priority to sputum microscopy of symptomatic people and those at risk for the disease, which "pushed" immunization with BCG vaccine to cover 70% -90% of people aged 15 to 20 years (40). Today, the WHO continues to programmatically control TB globally, but BCG vaccination is no longer recommended for the whole population, except for newborns (36).…”

Section: Modern Medical and Legal Environment Of Global Tuberculosis Burdenmentioning

confidence: 99%

The burden of tuberculosis as a permanent medical and legal challenge for mankind through centuries

Radović¹,

Đorđević²,

Božanić³

2021

Acta fac medic Naissensis

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Tuberculosis (TB) is a contagious disease, and throughout human history, it has been permanently opening numerous medical and legal questions, for which the answers are implied by the current social circumstances. In ancient times, insufficient knowledge of the etiopathogenesis of TB resulted in discrimination and isolation of patients. In the Middle Ages, kings used TB as a disease to secure their political power over the citizens, while TB culturally took a romanticized form during the 19th and 20th centuries, together with a great social phobia of contagion, disease, and dying on the other hand. Stereotypes were formed around all TB victims, while society tried to understand the nature of the disease and establish a civilizational relationship with it as a health problem having numerous social implications. Modern public health measures for the control of the TB pandemic were established after the discovery of the Koch bacillus in the 19th century. The invention and mass use of the BCG vaccine, the discovery of streptomycin and isoniazid, and the new era of TB treatment, with the consequent emergence of drug resistance, coepidemic with AIDS, neglect of public health facilities and the current COVID-19 pandemics threaten many legal rights of the infected and the sick and pose new challenges in its global elimination. Numerous attempts by society over the centuries to devise preventive and therapeutic measures for TB, through different levels of social obligations and activities, have had and continue to have a profound impact on the human race, shaping its further response to the victims of this deadly disease.

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Die Kontrolle der Tuberkulose in den Nachfolgestaaten der Sowjetunion am Beispiel Russlands

Cited by 6 publications

References 11 publications

Hepatitis B, Hepatitis C, tuberculosis and sexually-transmitted infections among HIV positive patients in Kazakhstan

Hepatitis B, Hepatitis C, tuberculosis and sexually-transmitted infections among HIV positive patients in Kazakhstan

Health system support and health system strengthening: two key facilitators to the implementation of ambulatory tuberculosis treatment in Uzbekistan

The burden of tuberculosis as a permanent medical and legal challenge for mankind through centuries

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