- •Lecture subject:
- •THE STRUCTURE OF TB DISPENSARY INCLUDES
- •MAIN TASKS OF THE TB DISPENSARY:
- •TUBERCULOSIS PREVENTION
- •TUBERCULOSIS PREVENTION
- •TUBERCULOSIS DETECTION
- •TUBERCULOSIS TREATMENT
- •DISPENSARY OBSERVATION
- •TB DETECTION IN CHILDREN
- •TB DETECTION IN CHILDREN
- •LIKEHOOD OF DISEASE INCREASES IN THE FOLLOWING SITUATIONS:
- •NEWLY DIAGNOSED
- •Obligatory minimum diagnostics
- •For active detection of patients with TB, three study methods are used:
- •GROUPS OF DISPENSARY OBSERVATION
- •GROUPS OF DISPENSARY OBSERVATION
- •GROUPS OF DISPENSARY OBSERVATION
- •TUBERCULOSIS
- •TUBERCULOSIS
- •3. TUBERCULINODIAGNOSIS is a set of diagnostic tests to determine the specific sensitization
- •TASKS OF MASS
- •TASK OF INDIVIDUAL
- •CONTRAINDICATIONS FOR CARRYING OUT
- •TREATMENT
- •IN PEDIATRIC PRACTICE, THE FOLLOWING COMBINATIONS AND DOSES OF ANTI-TB DRUGS ARE USED
- •If the source of infection is established and this patient is excreting acid-resistant
- •THANK YOU FOR YOUR ATTENTION
TASKS OF MASS
TUBERCULINODIAGNOSIS:
1.Identification of children and teenagers with tuberculosis.
2.Identification of persons at risk of developing tuberculosis for subsequent observation by a phthisiatrician (persons newly infected with MTB with a “turn” of tuberculin tests, with an increase in tuberculin tests, with hyperergic tuberculin tests, with tuberculin tests that are at a moderate and high level for a long time), if necessary – for preventive treatment.
3.Selection of children and teenagers for BCG revaccination.
4.Determination of epidemiological indicators for tuberculosis (infection of the population, annual risk of infection).
TASK OF INDIVIDUAL
TUBERCULINODIAGNOSIS:
1.Differential diagnosis of post- vaccination and infectious allergy (HRT).
2.Diagnosis and differential diagnosis of tuberculosis and other diseases.
3.Determination of the “threshold” of individual sensitivity to tuberculin.
4.Determination of the activity of the tuberculosis process.
5.Evaluation of treatment effectiveness.
CONTRAINDICATIONS FOR CARRYING OUT
MANTOUX TEST WITH 2 TU:
1.Skin diseases, acute and chronic infectious and somatic diseases (including epilepsy) during the period of exacerbation.
2.Allergic conditions, rheumatism in the acute and subacute phases, bronchial asthma, idiosyncrasy with severe skin manifestations during the period of exacerbation.
3.Quarantine for childhood infections in children’s groups.
4.Interval less than 1 month. after other preventive vaccinations (DPT, measles vaccinations, etc.).
TREATMENT
It is carried out in a children’s and adolescent tuberculosis hospital or sanatorium for 6-12 months against the background of a general regimen and a general diet (diet No. 11).
Chemotherapy involves a combination of the three main anti-TB drugs (isoniazid, rifampicin, pyrazinamide, or ethambutol).
IN PEDIATRIC PRACTICE, THE FOLLOWING COMBINATIONS AND DOSES OF ANTI-TB DRUGS ARE USED AT THE BASIS OF 1 KG OF BODY WEIGHT PER DAY:
•Isoniazid (10 mg/kg/day, orally, H);
•Rifampicin (10 mg/kg/day, orally, R);
•Pyrazinamide (25 mg/kg/day, orally, Z);
•Ethambutol (25 mg/kg/day, orally, E);
•Streptomycin (15 mg/kg/day, intramuscularly, S);
If the source of infection is established and this patient is excreting acid-resistant MTB strains, chemotherapy for contact children is carried out with 3-4 reserve anti-TB drugs, to which MTB sensitivity has been preserved.
Children and teenagers who have had TB are observed in the TB dispensary for 2 years.