Affiliation:
1. Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University
2. Russian Medical Academy of Continuous Professional Education
3. Kazan State Medical University
4. Sechenov First Moscow State Medical University
5. Kazan State Medical Academy, Branch of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of Russia
Abstract
In the Republic of Tatarstan (RT), as in the Russian Federation (RF), tuberculosis is the leading nosological form in the structure of occupational diseases (OD) from the effects of biological factors. Although tuberculosis, as a disease, is most common among medical workers (MW) of anti-tuberculosis institutions (80%), the remaining 20% of MW with diagnosed occupational tuberculosis are employees of the Bureau of Forensic Medical Service, neuropsychiatric institutions, and the Federal Penitentiary Service. The study aims to analyze the results of a sample with the tuberculosis recombinant allergen (TRA) "Diaskintest" in employees of the Bureau of Forensic Medical Service (FMS) for screening tuberculosis infection at periodic medical examination. Scientists conducted the study of the employees of the FMS Bureau by staging an intradermal sample with the drug "Diaskintest" (DST) in the conditions of a general medical network in the city of Kazan based on the State Autonomous Health Institution "City Polyclinic No. 18". The first stage of the study was the analysis of the results of tuberculin diagnostics using DST under the clinical recommendations "Latent tuberculosis infection (LTI) in children". The second stage of the study, prospectively, using a continuous method, taking into account contraindications to all employees responding to the TRA, conducted a comprehensive examination using computed tomography of the chest organs (CT CO) to exclude the tuberculosis process. We examined 64 employees of the Republican Bureau of the Forensic Medical Service of the Ministry of Health, Republic of Tatarstan, for tuberculosis infection with a breakdown of the TRA. The number of positive samples was 40 (62.5%), a negative result had 24 employees. In addition, the researchers conducted X-ray computed tomography of the chest organs. As a result, we diagnosed active tuberculosis in 4 employees, tuberculosis of questionable activity in 5, metatuberculous changes in 11 people, latent tuberculosis infection (without focal changes according to CT CO) in 14 people. We recommend using a skin test with the allergen tuberculosis recombinant DST at a periodic medical examination for the timely diagnosis of tuberculosis in the staff of the forensic medical examination.
Publisher
FSBI Research Institute of Occupational Health RAMS
Reference20 articles.
1. Garipova R.V., Strizhakov L.A., Umbetova K.T., Safina K.R. Occupational diseases of health care workers from exposure to infectious agents: the current state of the problem. Med. truda i prom. ekol. 2020; 60(2): 13–17. https://doi.org/10.31089/1026-9428-2020-60-2-89-92 (in Russian).
2. Stepanova T.F., Rebeshchenko A.P., Bakshtanovskaya I.V., Mazurkevich V.V. Assessing efficiency of epidemiological security system for the medical organization. Infekciya i immunitet. 2019; 9(3–4): 568–76. https://doi.org/10.15789/2220-7619-2019-3-4-568-576 (in Russian).
3. Kornachev A.S., Dmitrienko Yu.V., Semina N.A. Analysis of the reasons for the high activity of the epidemic process of tuberculosis among the staff of the bureau of forensic medical examination. Epidemiologiya i vakcinoprofilaktika. 2005; 3(22): 15–20 (in Russian).
4. Kornachev A.S., Stepanova T.F., Bakshtanovskaya I.V., Bragina E.A., Kalgina G.A., Kataeva L.V., Adler U.P. Organization of monitoring of biological safety of personnel of the Bureau of forensic medical examination and pathoanatomical departments, in terms of prevention of nosocomial tuberculosis infection. Ftiziatriya i pul`monologiya. 2012; 2(5): 76–177 (in Russian).
5. Clinical guidelines "Latent tuberculosis infection in children". Available at: http://obltub.ru/assets/files/antikorrupcionnaya-politika/kr-lti2.pdf