The developed situation now on a tuberculosis and an infection HIV - adverse as all over the world, and in Russia. The quantity sick of a tuberculosis, sochetannogo with a HIV-infection, will be enlarged [83], that should be reflected in augmentation of quantity of children, zabolevyoshih a tuberculosis against a HIV-infection as they are in same social medium and are the most acquisitive to the originator tuberyokuleza a population part.

Annually (f. № 61) in the Russian Federation 90 % - children at the age of 0-7 years are registered from 720 to 800 for the first time taped children of 0-14 years, sick HIV-infections, from kotoyoryh almost.

Way of a becoming infected of children of a HIV-infection - mainly periyonatalnyj. The share of children who have caught a HIV owing to perinatalnoj transyomissii, makes about 90 % from the general number of children of having HIV - an infection at the age from 0 till 14 years (3424 children from 3443 with a HIV-infection in 2010г.) . The most active birth rate of children of a HIV-infected began to be registered by women about 2004-2005, and for last 5 years zayoregistrirovano more than half of all sorts (58 %). On the termination of 2012 in Russia from mothers, sick HIV-infections, 100 000 children (95823 children), from them most of all in Sverdlovsk area (10,1 %), goroyode to Moscow (7,6 %), the Samara area (7,1 %), Irkutsk area (6,7 %), Moyoskovsky area (5,9 %), the city of St.-Petersburg (5,6 %) were born almost. There is dostayotochno high a risk of transfer of a HIV-infection from mother to the child: a HIV - the infection has been confirmed at 6069 children who were born from mothers, sick HIV-infections (6,3 % from number of born children).

The indicator of a registered case rate of a HIV-infection among deyotej 0-14 years (on 100 thousand children's population) has increased for last years (2005-2012гг.) on 28 % (with 2,6 to 3,6; 95 % of Dee 3,2-3,7).

The share sick of a tuberculosis, sochetannym with a HIV-infection, among deyotej yet so is great (2012г.): among the contingents consisting on the account concerning a HIV-infection, the share sick of a tuberculosis has made 1,6 %; among contingents sick of a tuberculosis the HIV-infected share has made 2,4 % (2,1 % - in 2009г.). However a case rate a tuberculosis of children from a HIV - an infection in tens times (in 37 times in 2012г.) exceeds an indicator zabolevaeyomosti children without a HIV-infection: in 2012 the case rate indicator sreyodi the first has made 608 on 100 thousand children with a HIV-infection, and an indicator zayobolevaemosti children on the average across Russia - 16,6 on 100 thousand population of 0-14 years. Among children sick of a tuberculosis, sochetannym with a HIV-infection, children of age group of 0-7 years (63,3 % in 2012г prevail.) . It is necessary to notice, that from 80 % to 98 % of children with sochetannoj an infection, consisting on the account in antituberculous establishments, are observed as patients with late stages of a HIV-infection. Prevalence of a tuberculosis at late stages in 6-8 times above, than among all children with a HIV-infection: 12,1 and 1,6 (2012г.) accordingly. Prevalence of a tuberculosis among children, sick HIV-infections, with late stages among age groups of 0-7 years and 8-14 years authentically did not differ (in 2012 - 13,0 % against 10,7 %; p> 0,05).

It is necessary to note: the analysis of the given federal forms of account (f.

№ 61, 33) shows, that diffusion sochetannoj infections in territories of the Russian Federation among children of age group of 0-14 years substantially neravnomeryono. It, first of all, is bound to non-uniformity of diffusion of a HIV - of an infection among adult population. The greatest share of sick HIV - an infection among children consisting on the account in antituberculous orgayonizatsijah concerning a tuberculosis, is observed in UFO - 5,1 % (3,2 %; 7,6 %), in PFO and SFO the share of such patients exceeds 2 % (an average index across the Russian Federation) - 2,5 % and 2,2 % accordingly. The least share of a HIV-infected deyotej among contingents sick of a tuberculosis in SKFO - 0,3 % and DVFO - 0,7 % that can be bound and to problems of revealing of such patients.

Besides, insufficient quality of collected data can influence differences of data on territories in a number of regions on section VICH/TB.

For monitoring improvement for children, sick of a tuberculosis, socheyotannym with a HIV-infection, the high-grade system of the account and otchetyonosti on sochetannoj is necessary for a pathology: entering of the additional information, kayosajushchejsja only children, in the form № 263 (the Card of the personal account bolnoyogo a tuberculosis, sochetannym with a HIV-infection), entering of necessary changes into forms of account state statistical nabljudeyonija.

Problems of our research included studying of implications tuberkuyoleza at children sick of a tuberculosis, sochetannogo with a HIV-infection, in usloyovijah a modern epidemic situation.

As a whole 358 children have entered into research sick of a tuberculosis. For revealing of features of clinical implications of a tuberculosis at children with a HIV-infection patients have been parted on 3 groups: 1 children sick tuyoberkulezom and a HIV-infection (166 persons); 2 children born from women, sick HIV-infections, but not infected HIV (with perinatalnym contact on a HIV-infection), sick of a tuberculosis (97 persons); 3 children sick of a tuberculosis from population (95 persons). The share of children at the age of 0-2 years has made 32,7 % (117 of 358), at the age of 3-6 years - 43,8 % (157 of 358) and at the age of 7-14 years - 23,5 % (84 of 358). Thus, the greatest number deyotej in research is presented by children of preschool age (3-6 years). Boys there were 49,2 % (176 of 358) and girls of 50,8 % (182 of 358). Among clinical forms of a tuberculosis about 12 years in all groups preoblayodal a tuberculosis of intrathoracic lymph nodes (TVGLU) (> 0,05) are elderly. At the age of 12-14 years in 3 group of patients diagnosed secondary forms of a tuberculosis (focal and infiltrativnyj) whereas in 1 group in it vozyoraste taped only a primary tuberculosis (TVGLU) or disseminiroyovannyj (generalised).

During research it is established, at children with a HIV-infection tuberkuyolez proceeds more hardly, than at children without a HIV-infection, including in comparison with children with perinatalnym contact on a HIV-infection. The beginning of disease at them was more often acute and subacute (62,6 %, 34 % and 37,7 %; Х2=19,8; r

<< | >>
Scientific source KLEVNO HOPE IVANOVNA. TUBERCULOSIS At CHILDREN, SICK HIV-INFECTIONS (prevalence, features of clinical implications, diagnostics, treatment, preventive maintenance). The dissertation on competition of a scientific degree of the doctor of medical sciences. Moscow - 2015. 2015

Other medical related information DISCUSSION OF THE RECEIVED RESULTS:

  2. the Table of contents
  3. Chapter 4 Discussion of the received results
  11. Chapter 5 Discussion of the received results