The assessment of different tuberculosis-related features in Moldova regions

Abstract

Background: Tuberculosis represents a social-related disease and for identifying the priority interventions for reducing its impact must be identified the main disparity features of patients. Material and methods: Global Competitiveness Report and Report of the National Centre for Health Management were used. The clinical study was retrospective, randomized, selective, and included 263 new pulmonary TB cases registered in three different Moldovan regions: Chisinau (center), Balti (north) and Cahul (south). Results: Attributable risk identified that in Chisinau compared to Balti predominated patients in economical vulnerable state, without health insurance, GeneXpert MTB/ Rifampicin sensible and those who successfuly finished the treatment. In Balti compared to Chisinau predominated chronic alcohol abusers, co-morbid patients, severe pulmonary tuberculosis, direct addressing to the hospital, patients infected with GeneXpert MTB/Rifampicin resistant strains of Mycobacteria. The major differences between Chisinau and Cahul groups, with predominance in Chisinau were homeless, co-morbid patients and those who successfully finished the treatment course. In Cahul predominated patients with rural residence, direct addressed to the regional hospital and severe forms of tuberculosis. Comparing the Balti and Cahul groups was established the predominance in Cahul of patients with rural residence, in economically vulnerable state and patient’s detection by general practitioner. In Balti predominated co-morbid patients, alcohol abusers, patients with severe forms of tuberculosis. Conclusions: Reduction of health care inequality will be achieved through social assistance of vulnerable groups and improvement of the general public life.