features of a tuberculosis at children and teenagers at the present stage

The problem of a tuberculosis at children in 21 century differs from similar problems in previous years and demands revision of the standard actions, both in the general pediatric service, and from phthisiatricians.

The differentiated approach in work ftiziopediatricheskoj and the general medical services in questions of preventive maintenance and early revealing of disease (Aksenova V. A, Klevno N.I., Sokolskaja E.A., Kavtarashvili S.M., 2011) is important

Among children and teenagers the high case rate is noted at the age of 14-17 years with a prevalence infiltrativnogo a tuberculosis (51,4 %). Growth MLU TB among children and teenagers becomes perceptible: fastness becomes perceptible to Isoniazidum of 41,4 %, rifampicin of 41,4 %, rifabutinu 6,9 %, to streptomycin of 31 %, PASK 13,8 % (Budritsky A.M., Pravada N.S., Kuchko I.V., Seryogin V. A, 2011).

Last decade widespread forms of a tuberculosis are more often diagnosed for children of early age in 2,5 times. At a source of infection of the child it becomes perceptible bakteriovydelenie with presence of medicinal fastness is more often, the quantity of the centres with a plural case rate a tuberculosis was enlarged. It causes importance of quality of inspection on a tuberculosis of an environment of the child (Aleksandrova E.N., Morozova T.I., 2011).

Disease at every third child is taped at carrying out tuberkulinodiagnosgiki, at every fifth - at the reference behind medical aid in medical institutions in this connection vigilance of pediatrists in respect of inspection of children on a tuberculosis is important. Negative shifts in
Clinical, morphological implications of a tuberculosis at children of early age affect its outcomes, the full resorption of available changes (Belova E.V., Stakhanov V. A, 2011, by Mordyk A.V., Tsygankova E.A., 2011) is extremely seldom observed

Last ten years, in comparison with the ten years' period (1985­1994), in a tuberculosis of organs of breath sick children had a number of negative changes. Tubercular process most adversely proceeds at children early and pubertatnogo age (Mordyk A.V., Plehanova M. A, 2011, 2012).

At children of the senior school age and teenagers at 56,9 % of patients the secondary tuberculosis of organs of breath is observed, prevails infiltrativnyj a pulmonary tuberculosis - 28,4 % - 30,6 %. The destruction of a pulmonary tissue becomes perceptible at 29,4 %, bakteriovydelenie - in 24,9 %, in 2,5 times there is a complicated current of a tuberculosis (Sirenko I.A., Shmatko S.A., 2004) is more often.

Prevalence of changes with a destruction in lungs and bakteriovydeleniem is enlarged with the years (Beloborodova N.G., Chugaev J.P., 2003). The traditionally often met form of a tuberculosis remains infiltrativnaja. In 2010 among for the first time taped teenagers primary forms of a tuberculosis (8,3 %), a specific gravity infiltrativnoj forms are registered has decreased to 50 %, the focal form is taped in 25 % of cases, a tubercular pleuritis in 5,5 %, disseminirovannyj a tuberculosis in 5,5 %, generalised in 2,8 % (Shurygin A. A, Rejhardt V.V., Barmina N.A., Novikova E.G., 2011).

Close dialogue in the conditions of a megacity has led to rising of a role of related, territorial and new kinds of contacts in the form of social communications of a family in disease of children by a tuberculosis. Carrying out of adequate preventive actions reduces risk of disease by the extended
And the complicated forms of a tuberculosis that defines necessity of revealing and application of active preventive maintenance at all kinds of contacts of children with adults sick of a tuberculosis (Belikova E.V., Chelnokova O. G, Kibrik B.S., 2011)

In Samara the indicator of a case rate of children a tuberculosis to the beginning 90х years of 20 centuries has grown to 17 on 100 thousand to the beginning of 21 centuries (Borodulin B.E., Baryshnikova L.A., Borodulin E. A, 2011).

The reasons of deterioration of an epidemiological situation were: depression of a standard of living, a defective food; growth of an alcoholism, a narcomania; population shift (a case rate among refugees 700 on 100 000 population); a high case rate in the centres (Ovsjankina E.S. from co-workers, 2011, Shilova M. V, 2010).

For the first time children who have ill with a tuberculosis in 60 - 70 % from socially not protected families. A specific gravity bakteriovydelitelej on the Moscow region among children reaches 18,5 %; teenagers of 72,7 %, with disintegration of a pulmonary tissue teenagers to 72,7 %, generalised forms were enlarged to 11,1 % (Ovsjankina E.S., 2007).

The tuberculosis at children is characterised by presence mainly (71 %) classical forms of a primary tuberculosis, prevail forms with a lesion of intrathoracic lymph nodes which can become complicated a lymphogenous dissimination, a meningocephalitis, become perceptible combinations to a lesion of vertebra. The structure kinicheskih disease forms has essentially changed. At children to 2006-2008 reduction of revealing of secondary forms of a pulmonary tuberculosis in comparison with the period 2000-2002 gg becomes perceptible. Frequency of revealing of a tuberculosis vnetorakalnyh localisations about 1994-1996 for 2000-2002 at children's age has decreased from 15,8 % to 6,8 % (r

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Scientific source Ahmerova Tatyana Efimovna. IMMUNODIAGNOSIS OF DIFFERENT MANIFESTATIONS OF TUBERCULOSIS INFECTION IN CHILDREN. Thesis for the degree of candidate of medical sciences. SAMARA - 2014. 2014

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