[Organization of detection of patients with tuberculosis in Moscow]

The authors studied the X-ray detection of patients with tuberculosis in Moscow over 5 years (1997-2001). The subject of the study was the Moscow population numbering about 7 million people to undergo fluorographic examinations and a group of new cases (more than 12,000) of pulmonary tuberculosis. The study has provided the following data: The most patients with pulmonary tuberculosis are detected in the polyclinics, general somatic and mental hospitals, and psychoneurological nursing homes; they amount to 74.8, 22, and 3.2%, respectively. The leading detection method among Moscow adults and adolescents is currently fluorography that detects 83.7% of the patients. The highest proportion in the structure of clinical forms is infiltrative pulmonary tuberculosis that amounts to 52.6%. Next is focal tuberculosis (14.9%); then in the descending order: disseminated tuberculosis (14.6%); tuberculosis of intrathoracic lymph nodes (4.1%); tuberculoma (3.9%), pleuritis (3.3%), caseous pneumonia (2.9%), cavernous and fibrocavernous tuberculosis (1.8%), and cirrhotic tuberculosis (0.5%). There are 69.3 of males and 30.7% of females in the structure of new cases of pulmonary tuberculosis. The unemployed able-bodied persons account for 34.5%, workers, 14.7%, disabled, 12.7%, and pensioners, 10.8%. Patients with pulmonary tuberculosis are most frequently detected in social risk groups. With this, the highest detection rate per 1000 examinees is 29.1% in homeless persons and 26.9% in migrants. In medical risk groups, tuberculosis is more frequently identified in patients with mental diseases, chronic nonspecific respiratory diseases, and alcohol and drug users (8.7, 5.3, and 2.5, respectively per 1000). In an epidemiological risk group, the highest detection rate is noted among persons who are in contact with patients with tuberculosis (5.4 per 1000). Examination of risk-group patients who amounted to 32.2% of those undergone fluorography detects 62.9% of patients with tuberculosis.