Tuberculosis in Siberia: 2. Diagnosis, chemoprophylaxis and treatment.
OBJECTIVE
To assess tuberculosis diagnosis, chemoprophylaxis and therapy in Siberia as a paradigm for the Russian Federation.


METHODS
Data was obtained from official sources and through visits to dispensaries and hospitals in 1994.


RESULTS
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.


CONCLUSIONS
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.
Drobniewski
F
F
Regional Tuberculosis Centre, Dulwich Public Health Laboratory, London, UK.
Tayler
E
E
Ignatenko
N
N
Paul
J
J
Connolly
M
M
Nye
P
P
Lyagoshina
T
T
Besse
C
C
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D011013:Pneumonectomy; D011859:Radiography; D012800:Siberia; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000517:prevention & control
D000995:Antitubercular Agents; D007538:Isoniazid