2. Social - medical features of disease by a tuberculosis at adult population.

From socially - caused diseases the tuberculosis remains to one of the social - dangerous illnesses amazing not only least socially protected groups, but also resulting to decrease in health of all layers of the population, including its able-bodied part.

As is known, the tuberculosis concerns to those diseases which are caused by the basic three kinds of factors: unsuccessful economic conditions, the social and economic and infectious reasons. The activator of a tuberculosis - a tubercular stick which, being in air, can easily get in respiratory ways. Distributes an infection of the patient, suffering the open form of a tuberculosis. As a source of an infection the cattle can serve and the patient with a tuberculosis.

In the literature allocate social and polyclinic groups of risk on disease by a tuberculosis.

To social groups of risk carry:

ﾷ Persons without the certain residence;

ﾷ Refugees;

ﾷ Migrants;

ﾷ The persons taking place in penitantiary establishments and released from them;

ﾷ Persons living in shelters, doss houses, boarding schools for aged;

ﾷ Patients of narcological and psychiatric establishments.

But the most extensive group is polyclinic group of risk into which enter:

ﾷ Patients infected HIV and patients AIDS;

ﾷ Patients with professional (dust) diseases easy;

ﾷ Patients with a diabetes;

ﾷ Patients with a stomach ulcer of a stomach and duodenal guts;

ﾷ Sick transferred cavitary operations on a belly cavity;

ﾷ Patients цшер chronic alcoholization, a narcotism and mental diseases; persons with residual posttubercular changes in easy and intrachest lymph nodes;

ﾷ Patients with nonspecific diseases easy;

ﾷ Patients, it is long receiving corticosteroid and beam therapy.

Distinguish some forms of tubercular defeat, but the greatest danger to the social worker represent pulmonary forms as most contagious.

The tuberculosis for Russia represents a sharp social - medical problem on many parameters. Desease a tuberculosis in comparison with 1991 has increased for 40 % and makes now 48.3 on 100000 population. Death rate has increased by 77,8 % (14,4 on 100000 population). Comes to light patients with the started forms of defeat more and more. From the accompanying diseases accompanying a tuberculosis, it is possible to note еру alcoholization, mental infringements, diseases of the endocrine lactas which make 40-45 % of disease.

Intense epidemiological conditions on a tuberculosis in a kind of deterioration of social and economic and ecological conditions of a life of the population, the big moving of the population from areas dangerous to residing, increase of the unemployment and constant psycoemotional an overstrain is kept. The marked unsuccessful factors, undoubtedly, result in decrease of the immunological protection and to growth of a susceptibility to a tuberculosis.

In many countries now sharply there is a problem of a HIV of an infection. Defeat of protective mechanisms of an organism frequently turns around development of a tuberculosis. Patients with a diabetes, leukosis also are subject to a tuberculosis. At children quite often the tuberculosis develops after reproach, etc. sharp infections. Contributing risk factor are bad living conditions, and also density. People living in such conditions, usually badly eat. All these components of poverty facilitate disease by a tuberculosis.