TB in the Russian Federation

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TB in the Russian Federation
Shona Schonning March 24, 2000
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• TB in Soviet-era Russia
• Centralized vertical program
• Improving nutrition
• BCG vaccine
• Surveillance and active case finding
• Sanatoria and Dispensaries
• Antibiotics, Surgery
• Steadily declining incidence and mortality

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Reported Notified cases of TB per 100,000
population
TB case notification in civilian population,
1970-1997 Source Punga
and Kapkov, 1999
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Changes contributing to the resurgence of TB in
Russia

• Economic, social political turmoil
• Breakdown of the health care system
• Growth of Multi Drug Resistant
• The Prison pump

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Prison Pop
General Pop
20
4.7
Prisons serving as a pump generating TB and
MDRTB
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Crowding, poor ventilation and poor nutrition in
Russian prisons promote TB transmission
Source PHRI
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Prevalence of HIV in Russia
Co-infection of HIV with TB and MDRTB is a major
threat!
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Surgery continues to be used for the treatment of
TB
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Conclusion

• The TB epidemic in Russia is at an early stage.
  It could get much worse!
• Much can be done in terms of
• Prison Reform
• Reliable drug supply incl 2nd line drugs
• Use of Direct Observation to ensure compliance
• Effective coordination of providers including
  international providers
• Ultimately poverty in Russia will need to be
  addressed