2. DOTS IMPACT TO TUBERCULOSIS IN LITHUANIA
NATIONAL TUBERCULOSIS AND INFECTIOUS DISEASES HOSPITAL, VILNIUS, LITHUANIA
E.Davidavičienė, D.Gaidamonienė, A.Sosnovskaja, R.Steigvilienė, I.Demšienė, A.Petraškaitė, E.Aleksaitė

3. THE LITHUANIA IS THE BIGGEST OF THE 3 BALTIC COUNTRIES
THE LITHUANIA IS THE BIGGEST OF THE 3 BALTIC COUNTRIES. THE TOTAL POPULATION IS OVER 3.5 MILION. THERE ARE 10 COUNTIES AND 44 REGIONS. THE CAPITAL IS VILNIUS.

4. MAIN REASONS FOR THE INCREASE OF TUBERCULOSIS:
MAIN REASONS FOR THE INCREASE OF TUBERCULOSIS: * SOCIAL AND ECONOMICAL CHANGES AND DETERIORATION * ECONOMICAL AND SOCIAL DETERIORATION * UNEMPLOYMENT * ALCOHOLISM * DRUG ABUSE *PATIENTS ATTITUTE TO THEIR DISEASE

5. THE PROGRAMME OF TUBERCULOSIS CONTROL AND PROPHYLAXIS WAS APPROVED ON THE 12 th OF MARCH 1998

6. THE MAIN PRIORITY OF TUBERCULOSIS PROGRAMME IS FOCUSED ON DOTS STRATEGY IMPLEMENTATION
(5 DOTS ELEMENTS)

7. DURING FOUR YEARS OF WORK THE NATIONAL TUBERCULOSIS CONTROL PROGRAMME OUTLOOK HAS HAD SEVERAL OBJECTIVES: * DOTS STRATEGY HAVE EXPENDED AND WILL BE COVER ALL POPULATION UNTILL 2005 YEAR; * INTEGRATION WITH PRIMARY HEALTH SECTOR IN TUBERCULOSIS CASE FOR EARLY DETECTION AND TREATMENT OF TUBERCULOSIS PATIENTS. * 14 MICROSCOPIES TUBERCULOSIS CENTRES PROVIDING PRIMARY HEALTH CARE; * THE AMBULATORY TREATMENT HAVE STRENGTHEN FOR TB PATIENTS; * STRENGHTENING SUPERVISION, MONITORING AND EVALUATION.

8. NEW CASES AND RELAPSES OF TUBERCULOSIS IN LITHUANIA (abs. n.)

9. INCIDENCE OF TUBERCULOSIS IN LITHUANIA (new cases and relapses)

10. NEW CASES OF TUBERCULOSIS IN LITHUANIA (abs. n.)

11. INCIDENCE OF TUBERCULOSIS IN LITHUANIA (new cases)

12. NEW CASES OF PULMONARY TB IN LITHUANIA (abs. n.)

13. INCIDENCE OF PULMONARY TB IN LITHUANIA (new cases)

14. INCIDENCE OF CHILDREN’S TB IN LITHUANIA

15. NEWCASES AND RELAPSES OF TUBERCULOSIS IN LITHUANIA IN 1998 (abs.n.)
Age
Males
Females
All
0-4 6 5 11
5-14 79 78
157
15-24
162
125
287
25-34
288
172
460
35-44
436
194
630
45-54
461
136
597
55-64
349
132
481
<65
318
235
553
2099
1077
3176

16. NEW CASES AND RELAPSES OF TUBERCULOSIS IN LITHUANIA IN 2002 (abs.n.)
Age
Males
Females
All
0-4 11 7 18
5-14 61 60
121
15-24 87 91
178
25-34
228
132
360
35-44
370
137
507
45-54
378
107
485
55-64
259 80
339
<65
241
170
411
unknown 1 -
1636
784
2420

17. NEW CASES OF PULMONARY TB IN LITHUANIA IN 1998 (abs.n.)
Age
Males
Females
All
0-4 - 2
5-14
15-24
124 83
207
25-34
241
128
369
35-44
148
517
45-54
353 86
439
55-64
245 72
317
<65
215
150
365
1547
669
2216

18. NEW CASES OF PULMONARY TB IN LITHUANIA IN 2002 (abs.n.)
Age
Males
Females
All
0-4 -
5-14 2 1 3
15-24 59 68
127
25-34
178
108
286
35-44
104
390
45-54
262 63
325
55-64
185 40
225
<65
173
300
unknown
1146
511
1657

19. PULMONARY TB NEW CASES BACTERIOLOGICAL CONFIRMED
Years
Smear positive
Culture negative/
not done
Culture positive
Smear negative/not done
Culture negative/not done
1998
368
792
1056
2000
341
751
735
2002
266
778
613

20. MORTALITY OF TUBERCULOSIS IN LITHUANIA (abs. n.)

21. MORTALITY OF TUBERCULOSIS IN LITHUANIA

22. TUBERCULOSIS DETECTION METHODS IN LITHUANIA (new cases and relapses)

23. TREATMENT OUTCOMES IN LITHUANIA IN 1998
Pulmonary TB new cases
Pulmonary TB relapses
TM+
sm-
cult-
abs.n. %
1. Cured
795
68,5 -
150
52,1
2. Completed
824
78,0 13
61,9
3. Defaulted
208
17,9
132
12,5 63
21,9 5
23,8
4. Failed 47
4,1 4
0,4 24
8,3
5. Died
110
9,5 96
9,1 51
17,7 3
14,3
6. Transferred
7. Still on treatment
Total
1160
100
1056
288 21

24. TREATMENT OUTCOMES IN LITHUANIA IN 2001
Pulmonary TB new cases
Pulmonary TB relapses
TM+
sm-
cult-
abs.n. %
1. Cured
853
73,8 -
193
51,7
2. Completed
508
82,3
3. Defaulted
134
11,6 50
8,1 61
16,4
4. Failed 30
2,6 1
0,2 34
9,1
5. Died
118
10,2 65
17,4
6. Transferred 4
0,3
7. Still on treatment 14
1,2 17
4,6
8. Not treatment 7
1,1 2
0,5
Total
1157
100
617
373

25. CONCLUSION: DOTS IMPACT TO TUBERCULOSIS SITUATION:
CONCLUSION: DOTS IMPACT TO TUBERCULOSIS SITUATION: * INCIDENCE TB NEW CASES ARE DECREASING FROM 76,3: (1998) TO 60,4: (2002); FROM 2826 (abs.n., 1998) TO 2097 (abs.n., 2002); * TB INCIDENCE (NEW CASES AND RELAPSES) FROM 81,4: (1998) TO 69,7: (2002); FROM 3176 (abs.n., 1998) TO 2420 (abs.n., 2002) * PULMONARY TUBERCULOSIS NEW CASES BACTERIOLOGICAL CONFIRMED %; %

26. * THE SUCCESS RATE OF TREATMENT IN 2000 WAS NEW CASES OF PULMONARY TUBERCULOSIS – MORE 75%, BUT SUCCESS RATE TREATMENT OF RELAPSES – ONLY 60%; * MDR TB PREVALENCE – 9% MDR TB AMONG TB NEW PATIENTS; * INTENSIVE NATIONAL TRAINING SESSIONS OF GP AND NURSES.