TB in Ukraine Vasyl Melnyk

Since 1995 TB epidemic in Ukraine < 10 10-24 25-49 50-99 > 100

TB incidence in Ukraine, 1992 - 2002 (per 100,000 population)

TB incidence in Ukraine, 2002 (per 100,000 population) Чернигов Сумы Луцк Ровно Житомир Львов КИЕВ Харьков Хмельницький Полтава Луганск Тернополь Черкасы Винница Ивано-Франковск Днепропетровск Ужгород Кировоград Донецк Черновцы Запорожье Николаев Одесса Херсон < 80,0 > 80,0 Симферополь Севастополь

MBT+ patients make 1/3 instead 2/3 Each hour in Ukraine 4 persons fall ill from TB and 1 dies from TB

Structure of TB patients in 2002

TB mortality rates in Ukraine, 1992–2002 (per 100,000 population)

Died from infections and parasitic deseases in 2002 in Kiev

Purchase anti-TB drugs from the State budget

Expenses from local budgets

Economic losses from TB

TUBERCULINODIAGNOSIS

X-RAY

SPUTUM BACTERIOSCOPY General medical service on 2045273 SB has spent 8487882,95 grn. (effectiveness of finding 1-2 %) TB service on 450477 SB has spent 1869479,55 grn. (+ culture examination) It is spent 10,4 mln. grivnas without results.

CULTURAL EXAMINATIONS TB service has spent 8705029,55 grn on 972629 cultural testings. On 1 new patient it is spent 268,5 grn. on cultures only. Results is bad. There is no statistics of resistances. The resistance is not examined to drugs ІІ lines. Testings are not standartized.

Casefindings TB patients in groups of risk (Kiev)

Resistance TB in Ukraine (%)

TB in AIDS patients (%)

TB incidens in prisons (per 100,000)

TB in medical workers

Parameters of treatment

Unsolved problems (1): 1) from 27 administrative territories DOTS is only in 2 (Donetsk obl., Kiev); 2) registration-forms of account are not adapted to international, therefore there are no many data and they are not comparable; 3) low efficiency of a smear microscopy, as there are bad laboratories;

Unsolved problems (2): 4) referens-laboratory does not work; 5) chaotic screenings tuberculin-test, x-ray and other anti-TB activites; 6) standart treatment of patients is not ewerywhere applied; 7) it will not be carried out cohort-analysis;

Unsolved problems (3): 8) drugs of II lines are uncontrolledly used with unreliable definition of sensitivity to them; 9) there is no centralized register of patients and monitoring is not adjusted; 10) selected assignments for TB are irrationally used. Thank You!