ABSTRACT
The paper deals with organizational measures for detection and treatment of homeless persons with tuberculosis in Saint Petersburg. A total of 1653 homeless tuberculosis patients were followed up in 1991-1997. There was high incidence of tuberculosis in homeless persons (30 detected per 1000 examinees. All agencies, facilities, and services should participate in detecting and treating tuberculosis among homeless subjects. Large-scale solution of this problems requires a package of measures by providing additional funds stipulated by a regional goal-oriented tuberculosis control programme.
Subject(s)
Communicable Disease Control/organization & administration , Ill-Housed Persons , Tuberculosis/prevention & control , Communicable Disease Control/trends , Disease Outbreaks/prevention & control , Humans , Retrospective Studies , Russia/epidemiology , Tuberculosis/epidemiology , Urban PopulationABSTRACT
For 5 years the authors observed isolated abdominal tuberculosis in 6 patients. Five of them who were urgently operated upon had perforations of the tuberculous ulcers of the intestine. A specific character of the inflammation was confirmed by histological investigations. Four patients are described in detail. One of them had six perforated tuberculous ulcers of the jejunum. All these patients died. Recommendations are given how to improve the diagnosis of abdominal tuberculosis and treat patients with this severe disease.
Subject(s)
Intestinal Perforation/etiology , Intestine, Small , Tuberculosis, Gastrointestinal/complications , Adult , Aged , Aged, 80 and over , Fatal Outcome , Female , Humans , Intestinal Perforation/pathology , Intestinal Perforation/surgery , Intestine, Small/pathology , Intestine, Small/surgery , Male , Middle Aged , Peritonitis/etiology , Peritonitis/pathology , Peritonitis/surgery , Tuberculosis, Gastrointestinal/pathology , Tuberculosis, Gastrointestinal/surgeryABSTRACT
Tuberculosis was first recognized by a phthisiothera-pist in 52 patients and in 3 cases at autopsy at the admission and resuscitation units. Out of 55 patients, 39 (71 +/- 6.1%) were found to have acute, general processes (subacute dissemination and acute military tuberculosis, caseous pneumonia, multiple preliminary extrapulmonary diseases). Six patients died at the Institute, after referral to tuberculosis dispensaries, there were 11 and 9 deaths at months 1 and 6, respectively. Mortality was 47.3 +/- 6.7%. According to the data of emergency x-ray study, the diagnosis to be correct in 87.3 +/- 4.2%. As high as 25% of new cases of tuberculosis were detected at somatic hospitals in 1992 - 1994. Therefore, all patients admitted for pulmonary complaints of general toxic syndrome should immediately undergo X-ray, sputum test for Mycobacterium tuberculosis, and a phthisiotherapist's examination.
