Drobniewski F, Tayler E, Ignatenko N, Paul J, Connolly M, Nye P, Lyagoshina T, Besse C
Regional Tuberculosis Centre, Dulwich Public Health Laboratory, London, UK.
Tuber Lung Dis. 1996 Aug;77(4):297-301. doi: 10.1016/s0962-8479(96)90092-1.
To assess tuberculosis diagnosis, chemoprophylaxis and therapy in Siberia as a paradigm for the Russian Federation.
Data was obtained from official sources and through visits to dispensaries and hospitals in 1994.
Tuberculosis disease and cure is classified according to a Dispensary Group Register based principally on clinical and radiological criteria. Isoniazid is widely used for chemoprophylaxis and post-therapy and may be linked to high levels of isoniazid resistance. Combination drug therapy is individualized, frequently changed, and given orally, parenterally or intra-bronchially. Galvanization, autotransfusion of ultra-violet irradiated blood, antioxidants and steroids are used as adjunct treatment. Ambulatory treatment is uncommon. Surgical treatments including lobectomy and pneumonectomy are used in 5-10% of patients.
Tuberculosis is increasing in Siberia. An improved drug supply using short course standardized regimens is required supported by high quality co-ordinated bacteriological services. Surgery retains a useful role, but many adjunct therapies should be abandoned.
