3. The parameters determining desease by a tuberculosis.

Social workers should know some parameters determining desease by a tuberculosis.

Infected a tuberculosis is a percent of the persons positively reacting on tuberculin. his parameter testifies to potential of a tubercular infection among the population as from among infected 2-3 % fall ill with a tuberculosis.

Decrease in a parameter of the infected the population testifies to decrease in the centers of an infection and an opportunity of its distribution and, hence, reduction of a threshold of probability of disease by a tuberculosis which is equal 0,03 %.

During too time it is necessary to realize that essential decrease of the infected of the population is possible only under condition of enough full change of infected generation not infected.

Desease a tuberculosis. This number of again registered patients with a tuberculosis, and a level of defeat by a tuberculosis. Desease or morbidity of the population is one of the parameters used at the organization of antitubercular work.

The parameter of desease a tuberculosis should take into account that fact, that not less than 30 % of new cases arises not due to primary infected, and owing to reactivation tubercular process. Such position testifies that adverse epidemiological conditions is supported by a high level of the infected of the population, a plenty of patients with inactive forms of defeat and patients with long forms of illness. Last circumstance especially should guard the social workers having direct contact to socially dependent contingent of the population.

It is necessary to pay attention that up to 25 % of patients with the revealed tuberculosis have the pulmonary the form of defeat most dangerous in view of an opportunity of the infected of associates.

It is possible to note and that fact, that about 15 % of patients with a tuberculosis come to light after routine inspections, switching and radiological inspections.

The great value for the epidemiological characteristic on a tuberculosis has such parameter, as death rate from a tuberculosis.

Three types of lethal outcomes from a tuberculosis are allocated:

1. Death owing to disease of long-term prescription (a chronic tuberculosis);

2. Death at presence of other illnesses;

3. Death from a progressing tuberculosis of "small" duration.

The analysis of the reasons of distribution of a tuberculosis shows direct communication of this phenomenon with a level of an economic life and culture of a society, development of a science, introduction in practice of scientific achievements, with a foresight of mass preventive and medical actions, etc.

For social workers have essential value shifts in disease by a tuberculosis, caused by change of the external reasons, as is a subject of its studying. Determining factors in development of a tuberculosis there are social and economic transformations to a society, volume and quality of treatment-and-prophylactic actions, a condition of a level of immunity, ecological changes and corresponding evolutionary and adaptive changes in system the person - activator.

Taking into account proceeding falling of a standard of life, increase in number of persons without the certain residence, deterioration of conditions of stay of a contingent of corrective-labour establishments and steady growth of the alcoholization, it is necessary to predict unsuccessful epidemiological position on a tuberculosis

«Urgent measures of struggle against a tuberculosis in Russia in 1996-2000 » are specified in the Federal program the following reasons of sharp deterioration of epidemiological conditions:

- reduction of mass preventive inspections and, hence, reduction of active revealing of patients by a tuberculosis;

- the delayed, overdue revealing of patients resulting in change of structure of forms of a tuberculosis and increase of number died from it in the first year after revealing;

- deterioration of the account and the registration, sick migrants because of a plenty, refugees, etc.;

- decrease in attention of medical workers and societies to a problem of contacts with bacillar patients (deterioration of preventive work in the centers of a tubercular infection, decrease in an opportunity of isolation of healthy children and teenagers from a source of an infection, etc.);

- deterioration of hospitalization and reduction of its volume;

- deterioration of the medical control over patients (insufficient maintenance with medicines, reduction of availability of medical aid);

- insufficient supply of regions by a tuberculin, disinfectants;

- Absence of preventive fluorographic surveys in the base program of obligatory medical insurance;

- underacquisition of the corresponding services the staff that promoted by insufficient measures of social protection on a background of high desease a tuberculosis of workers of antitubercular establishments.