The evolution of tuberculosis among the students

Abstract

Introduction. Tuberculosis (TB) remains a major medical and socio-economic problem of public health, growing alarmingly. There are about 10 million new cases of tuberculosis and more than 1.5 million deaths worldwide each year. It is one of the top 10 causes of death in the world. In recent decades there has been a constant "rejuvenation" of TB. Contact with TB-infected patients is known as a major factor of Mycobacterium tuberculosis infection. Aim of study. The features of the evolution of pulmonary TB, diagnosed in student-patients. Methods and materials. A descriptive, retrospective study was conducted for the period 2018-2020. The subjects of the study consisted of 36 cases of pulmonary TB diagnosed in students from different educational institutions in Chisinau. The data was collected using the information system of tuberculosis monitoring and assessment (SIME TB) and the patient's medical history, archive’s database. Were estimated the clinical symptoms, results of bacterioscopic examination of liquid and solid culture. The highsensitive detection method as molecular-genetic test GeneXpert MTB / RIF), thoracic radiology examination and treatment strategy were assessed. Results. The males predominated about three times according to follow-up.The vast majority of the patients lived in rural areas - 29 (89%) and only 7 (11%)- in Chisinau. Was observed that students from rural areas had a more difficult adaptation period, living in dorms or in dissatisfied conditions, which exposed them to higher risk for tuberculosis. The active and passive patient’s screening was applied in approximately 1:1. According to research, the broncho-pulmonary syndrome was most common, especially cough - 90%, followed by intoxication and temperature’s rising in 69% of cases. Among the comorbid conditions were the mentioned digestive tract pathology -15 (41.6%), previous allergy to various foods and drugs - 12 (33.3%), urinary tract infections - 10 (27.7%), Central Nervous System (CNS) impairment - 7 (19.4%), history of trauma - 5 (13.8%) cases. The infiltrative pulmonary tuberculosis was the most common clinical form of TB, found in 32 (88.8%) of patients. Nodular pulmonary tuberculosis and pleurisy of tuberculous origin were detected in 2 (5.5%) cases. From the total number of patients included in the study, the microbiological etiology of TB was established only in 27 (75%) cases, when in 9 patients (25%) it was not confirmed. According to outcomes, complete recovery from TB was in 25 students (69.4%), enclosed treatment-in 9 (25.0%) patients and in 2 (5.6%) cases the therapeutic failure was found. Conclusion. The medical-biological and social factors increase the risk of TB in students due to adaptation period, unfavorable nutrition and living conditions. Early diagnosis and correct treatment of TB lead to benign evolution and favorable outcomes.