Events for the single day against tuberculosis. For World Tuberculosis Day

GBOU SPO (SSUZ) "Chebarkul Vocational College".

Open event

Developed by: Biology and Chemistry Teacher

Shusharina Valentina Mikhailovna.

2016

annotation

Working at the Chebarkul Vocational College and visiting other places, I noticed that our children have a bad habit of spitting anywhere in the corridor, in classrooms, on the porch of the educational institution. This situation prompted me to create a development about the most terrible disease like tuberculosis. This development can be used by masters and class teachers when conducting extracurricular activities. This event does not have to be held on World Tuberculosis Day; it can be held at any other time since this problem is relevant.

Open event

"WORLD TUBERCULOSIS DAY"

Target : prevention of tuberculosis in children - preventing infection and preventing the development of the disease.

Tasks:

1 .Acquaintance with information about the characteristics of tuberculosis infection, the causative agent of tuberculosis - Koch's bacillus, the mechanism of infection, the source of infection, groups of people at risk of infection, factors contributing to the disease, symptoms of the disease.

2. Familiarization with the main methods of preventing tuberculosis in children - BCG vaccination and chemoprophylaxis.

3. The importance and necessity of diagnosing tuberculosis - Mantoux test and fluorographic examination.

4. Consideration of sanitary and hygienic measures necessary for compliance by each person in order to avoid infection with tuberculosis.

5. Fostering a culture of behavior.

Opening speech by the teacher (leader):

World Tuberculosis Day is a memorable date celebrated annually on March 24 at the initiative of the World Health Organization (WHO), which declared tuberculosis a global problem in 1993. The purpose of World Tuberculosis (TB) Day is to raise awareness of the global TB epidemic and efforts to eliminate the disease.

March 24 was chosen due to the fact that on this day in 1882, German microbiologist Robert Koch announced his discovery of the causative agent of tuberculosis.

Correspondent:

Currently, tuberculosis annually claims the lives of about 1.6 million people, the vast majority of whom (about 95%) are residents of developing countries. Tuberculosis kills more adults each year than any other infection. In third world countries, tuberculosis causes about 26% of deaths.

The situation with tuberculosis in general is most serious in African countries. Africa accounts for about 29% of all cases on the planet and 34% of all deaths from this infection. The incidence of tuberculosis in Africa has doubled over the past 15 years, increasing from 149 to 343 cases per 100 thousand population. There is an alarming increase in the registration of cases of antibiotic-resistant forms of tuberculosis, the occurrence of which in Africa is also experiencing extremely unfavorable trends.

The most dangerous situation in the world in terms of multidrug-resistant tuberculosis - its most lethal and dangerous form - has developed in the Russian Federation. In the Russian Federation in 2009, 105,530 new cases of active tuberculosis were identified.

1 General practitioner (brief history of the development of tuberculosis):

Tuberculosis is a chronic relapsing disease of humans and animals caused by mycobacterium tuberculosis.

Tuberculosis has been a disease of the human race since time immemorial. It has existed for centuries as a chronic, widespread epidemic disease. Its clinical picture was well known to ancient doctors and was excellently described in the works of Hippocrates. The modern era in the study of tuberculosis began with the discovery in 1882 of R. Koch of tuberculous mycobacteria and their role in this disease. The discovery of X-rays (also known as X-rays) in 1895 by Wilhelm Roentgen was another important milestone in the study of the disease.

In the mid-19th century, for reasons not yet fully understood, the incidence of tuberculosis began to decline. Undoubtedly, the most important role in this belongs to improving hygienic conditions and raising the standard of living, including nutrition.

In most countries of continental Europe, immediately after the Second World War, there was a sharp rise in mortality from tuberculosis, but, starting in 1947, this was followed by a rapid decline due to the advent of new antibiotics and the development of surgical treatments. However, in the late 1980s and early 1990s, there was a new sharp increase in the incidence of tuberculosis due to the spread of AIDS, which increases susceptibility to tuberculosis, and also due to the influx of immigrants with tuberculosis upon entry into the country. High incidence of tuberculosis persists in many developing countries where modern anti-tuberculosis drugs are difficult to access.

Tuberculosis affects millions of people and remains a major health problem worldwide. They get it at any age. Most patients are identified in poor areas of large cities.

Transmission of the infection from person to person occurs through inhalation of particles of infected sputum sprayed during coughing. Intensive transmission of tuberculosis through contaminated cow's milk is still observed in some areas of the world, but it has been virtually eliminated in developed countries through pasteurization of milk and testing of livestock for tuberculosis. The infectiousness of tuberculosis is low; infection with a subsequent active process usually occurs only with prolonged close contact with the patient. Mycobacterium tuberculosis enters the respiratory tract of many healthy people, but most of them are quite resistant to infection. An X-ray examination of the lungs of practically healthy individuals who have not had clinical signs of tuberculosis in the past often reveals old, healed tuberculosis lesions. Infection with tuberculosis occurs predominantly through inhalation, so the primary lesion is observed mainly in the lungs. However, Mycobacterium tuberculosis can penetrate all parts of the body, usually as a result of secondary spread of the pathogen from the lungs. Therefore, for public health, the problem of combating tuberculosis comes down mainly to the fight against pulmonary tuberculosis.

Correspondent:

O. Kuznetsov, chief physician of the State Budgetary Institution "Otb of Chebarkul", in the materials of the issue dated March 21, 2012, indicates that tuberculosis is taking the form of an epidemic not only in the country, city and region, but also in the world.

About 5,000 people die from this disease every day around the world. The deadly combination of tuberculosis and HIV infection, as well as the spread of multidrug-resistant (MDR) tuberculosis, threatens even more serious consequences. The economic consequences of tuberculosis are noticeable, since the majority of cases are among the working population.

The morbidity and mortality rate in our country is 7–8 times higher than the European average. Russia is among the 22 countries with the highest incidence of tuberculosis. Many doctors believe that this disease has taken the form of an epidemic in our country. Every year in Russia about 117–120 thousand people fall ill with tuberculosis, and about 25 thousand die from it.

In 2011, 2 people died from tuberculosis in the Uysky municipal district. 29 people fell ill for the first time. In total, 59 people are registered as active patients with tuberculosis, of which 21 are bacteria excretors. If we compare these indicators with the regional average, the situation can be assessed as unfavorable. There are few reasons for optimism; everything can change for the worse at any moment, because... The layer of active and undetected tuberculosis patients is quite large. In the Uyskaya Central District Hospital for three years now there has been no local phthisiatrician; appointments are conducted by a doctor from the village. Kundravy once a week. There remains a relatively low percentage of population coverage with fluorographic examinations in the region.

Specialized medical care for patients with tuberculosis in the territory of the Chebarkul municipality, Chebarkul and Uysky MR is provided by the State Budgetary Healthcare Institution "Regional Tuberculosis Hospital of Chebarkul", which includes two inpatient departments in Chebarkul, adult and children's tuberculosis rooms in Chebarkul, a clinic and a hospital in the village Kundravy. The objective of the institution is the diagnosis, treatment and prevention of tuberculosis in the assigned territory. As well as more active involvement of the population in a common cause - curbing the spread of tuberculosis infection. This means involving the population in conscious participation in protection against the disease (vaccination, fluorographic examinations, diagnostic samples and tests). Knowledge of the characteristics of the transmission of tuberculosis infection and its manifestations is necessary for every person, every family, because timely adoption of measures can prevent not only the transmission of infection, but also the development of the disease.

Teacher (Leader):

Tuberculosis is a contagious disease. It does not spare any human organ. The most common “arena” in which the disease plays out is the lungs – the main “entry gate” of this infection.

The causative agent of tuberculosis, the tuberculosis bacillus, is a microbe visible only under a microscope and is most often found in the secretions of tuberculosis patients - in pus, urine, and especially in sputum.

Koch stick

What should you do to protect yourself from becoming infected with tuberculosis?

2 Phthisiatrician:

1. Every student is obliged to maintain cleanliness in the rooms and in the classroom.

2.Ventilate the room more often. During the warm season, keep the window open all day. In winter, ventilate the room 3-4 times a day for 15-20 minutes. At school, the classroom is ventilated every break.

3.Sweep the floor only with a wet method. Wipe off dust from cabinets, tables, chairs, window sills and other objects only with a damp cloth.

4.When coughing or sneezing, turn away from your interlocutor. When coughing, cover your mouth with the back of your left hand, but it is better to use a handkerchief.

5.Use a separate towel, tooth powder, a separate toothbrush, a mug, and separate dishes.

6.Each student must have a separate bed.

7.Avoid random kisses and handshakes.

8.Do not smoke, do not drink alcoholic beverages (alcohol). Smoking and alcoholism weaken the body and lead to tuberculosis.

9.Do not clean dirty clothes and shoes in the room.

10. Strictly follow the daily routine: eat on time, go to bed and get up, do not eat dry food.

11.Wash your hands before every meal and after every visit to the toilet.

12.Temper your body with the right regimen, walks, and nutrition. Accustom yourself to sleep with the window open.

13. Do exercises in the morning, after which you wipe your body with water at room temperature. At any time of the year, engage in physical exercise and sports.

Teacher (leader):

In a strong, hardened body, tuberculosis pathogens quickly die without causing disease. Schoolchildren should know that tuberculosis is a curable disease.

Periodic medical examinations of students at school, checks using the Mantoux reaction,

x-ray examination

help to identify tuberculosis disease in a timely manner, and this is the key to its successful treatment.

If a student is diagnosed with tuberculosis, he must be conscious about his treatment, carefully and patiently follow all the doctor’s instructions - this will help defeat the disease.

Students should know that tuberculosis is a curable disease. To protect themselves from this disease, every person should know about the causative agent of tuberculosis, the ways of its spread and how to avoid infection.

3 Microbiologist:

Tuberculosis bacilli are tenacious. They last up to 3 months in dust, and up to a month in spit dried on the sidewalk. In soil, in water, in damp and dark rooms, they remain viable for up to a year; on the floor, on walls, objects - up to 6 months. They are not afraid of frost: at a temperature of minus 230, mycobacterium tuberculosis does not die for 7 years, they are not killed by a temperature of minus 2690 C. However, they cannot withstand even short-term boiling. The sun kills them in 1-2 hours, and scattered ultraviolet rays - in 5-6 hours. In damp and dimly lit rooms, people are more likely to get tuberculosis. It is no coincidence that the proverb says: “Where the sun rarely shines, there the doctor often comes,” and therefore the patient is given the sunniest possible room.

The source of tuberculosis infection is a sick person or sick animals, and very rarely birds.

Teacher:

How do microbacteria enter the human body?

4 Phthisiatrician:

The causative agent of tuberculosis enters our environment along with the secretions of people and animals suffering from tuberculosis. Two methods of infection are of primary importance: through the air (aerogenic route) and through food (alimentary route). The second method is much more common. Infection through the air occurs when inhaling droplets of fresh sputum or dust particles containing dried sputum of a patient with tuberculosis. It is known that a patient with tuberculosis secretes a huge number of pathogens with sputum (up to 15-20 million per day). The smallest droplets of sputum containing pathogens not only disperse in the air near the patient, but also spread to a considerable distance from him: when coughing - 2 meters, when sneezing - up to 9 meters. The danger of infection in this way increases with close communication with the patient and his failure to comply with basic hygiene rules. When droplets of sputum containing pathogens settle on the floor and dry out, conditions are created for airborne dust infection. This is especially dangerous in cases where the patient spits out sputum on the floor, as a result of which a large number of tuberculosis pathogens accumulate on dust particles. It is easy to imagine how much the danger of infection in this way increases if the room is cleaned using a dry method. Dust particles rise into the air and easily penetrate the respiratory tract of healthy people.

Ways of infection with tuberculosis:

1. Infection with tuberculosis through food most often occurs when drinking unboiled milk from cows with tuberculosis.

2. We should not forget that infection through nutritional means can occur when sharing utensils with a person suffering from tuberculosis.

3. You can become infected through kisses, when finishing smoking someone else’s cigarettes, through household items, books, toys, handshakes, etc.

4. Children are especially sensitive to tuberculosis infection, and therefore they should not be entrusted with caring for seriously ill patients with tuberculosis, who cannot cope without outside help. More often, tuberculosis is transmitted to children from sick parents who violate hygiene rules.

5.Flies, cockroaches and other insects are also carriers of Mycobacterium tuberculosis.

Teacher (leader):

Measures to prevent tuberculosis.

5 Nutritionist:

1.Healthy lifestyle:

proper nutrition (sufficient consumption of meat, dairy products, vegetables and fruits);

regular physical activity;

complete rest;

quitting smoking, alcohol, drugs.

2. Compliance with personal hygiene rules (washing hands, washing dishes using detergents and running water), wet cleaning and ventilation of residential premises.

3. Mandatory heat treatment of meat and milk.

4.Use of personal hygiene products and utensils.

5. Mandatory BCG vaccination at birth and revaccination at 6-7 years.

6. Timely diagnosis of tuberculosis and completion of the full course of treatment.

Final words of the teacher (leader):

We wish you good health!

When you are healthy and full of strength, then it seems to you that everything is within your power, and at that moment when an illness ties you down in bed, you begin to understand that recovery is only in your hands and not one doctor, healer or medium can restore your health and strength.

Let's stop the epidemic together!

It is the prevention of tuberculosis that plays a big role as the main measure that will reduce the number of people affected by Koch's bacillus. Focal pulmonary tuberculosis is a dangerous disease and preventive measures are fundamental to avoid mass epidemics, because tuberculosis is a disease that knows no race, no boundaries, no matter a person’s social origin or gender.

Prevention comes first

Throughout the history of mankind, there are known great people who died from tuberculosis, who were not saved from the fate of even the recognition of millions of fans. Anton Chekhov and Frederic Chopin were among them, and who knows, maybe in our time an evil fate would not have befallen them and they would have pleased the world with new works that were included in the golden fund of world classics.

A conversation “Let's stop tuberculosis” took place at the Bolsheminsk Library.

The librarian said that on March 24, 1882, the German microbiologist Robert Koch announced his discovery of the causative agents of tuberculosis. He found out that the cause of the disease was a tiny microbacterium. As it should be, the discovery perpetuated the memory of the scientist; since then, the causative agent of tuberculosis has been called Koch’s bacillus.

Readers learned about the main sources of infection, who is most susceptible to tuberculosis, the factors that contribute to the development of the disease and its prevention.

A thematic exhibition “Koch's Wand” was prepared for the event.

Readers were offered books and articles from magazines on the prevention and treatment of tuberculosis.

In the Vvedensko-Slobodskaya library, together with paramedic S.V. Ignatieva. A conversation was held for readers “Caution - tuberculosis!”

Head of the Kildeevskaya Library Mukaeva G.N. spent a health hour with readers “Dangerous Disease of the 21st Century” and talked about the fact that in recent years there has been an increase in the incidence of tuberculosis, which claims much more human lives than any other infectious disease, and gave ways to prevent tuberculosis. Each participant received a booklet “Prevent Tuberculosis.”

The head of the Korguzin library L. Gracheva, together with workers from the Children's Department and the FAP, held a health hour “Protect yourself from tuberculosis” for students in grades 5-9 of the Korguzin school. Using a video, schoolchildren were told about the discovery of Koch’s bacillus, the main sources of infection and factors contributing to the development of the disease, about methods and prevention of tuberculosis.

The paramedic drew the students' attention to the fact that it is necessary to conduct Mantoux tests annually, because this method makes it possible to identify the fact that a child is infected with tuberculosis and take the necessary actions to treat the disease in a timely manner.

The Patrikeevskaya Library issued a sanitary bulletin for the prevention of tuberculosis “Stop tuberculosis!”

Users are presented with information about the disease tuberculosis, symptoms of tuberculosis, how the disease is transmitted, the favorite habitat of Koch's bacillus - the lungs, risk factors that contribute to the development of tuberculosis and what to do to avoid contracting this disease.

The heads of the Russian-Makulovskaya and Tatarsko-Makulovskaya libraries, together with medical worker Minnullina Lenisa Khakimovna, conducted a health lesson “How to avoid getting tuberculosis” for students of the Makulovskaya school.

Leniza Khakimovna talked about how to protect yourself from this disease and listed several of the most important risk factors that are well known to everyone - smoking, alcohol, an antisocial lifestyle, poor nutrition. It is advisable to eat well, exercise regularly, and try to live a rich and active life. In addition, do not forget about vaccination of children and regular tuberculin diagnostics.

Head of libraries Pershina N.A. and Khisamova M.V. supported the conversation with literary and life examples. They emphasized the need to constantly keep your body, clothes and home clean. It was not for nothing that Korney Ivanovich Chukovsky said: “We must, we must wash ourselves in the mornings and evenings...”

Of course, you need to do more than just wash your face. You need to wash your hands, brush your teeth, take a shower, wash with soap and a washcloth, clean your shoes and clothes, ventilate the room, regularly do wet cleaning in your apartment, keep your yard clean, never throw garbage on the streets past the trash can... A healthy lifestyle begins from cleanliness!

All these rules were described in the leaflet “Prevention of Tuberculosis” offered to children.

Head of the Naberezhnye-Morkvash Library Prokhorova I.R. and head of the FAP Vasilyeva T.A. conducted a preventive conversation “Protect yourself from tuberculosis” with students of the Naberezhno-Morkvashskaya Secondary School.

Paramedic Tatyana Aleksandrovna strengthened children's knowledge about tuberculosis, the source of infection, symptoms of the disease, diagnostic methods, methods of prevention and treatment. Librarian Ilmira Rinatovna warned about risk factors for the disease and recommended maintaining a healthy lifestyle. Sports, healthy eating and hardening are the key to the health of a young body.

At the end of the conversation, the children were given leaflets “Prevention of tuberculosis.”

Head of the Vakhitov Library Salimullina S.L. in the village of Yanga-Yul, together with the employee of the FAP, Amudbaeva I., held a preventive conversation with the village residents “What is tuberculosis?”, at which those present received answers to their questions about this problem.

The librarian introduced the materials from the thematic display “A disease that knows no boundaries.” At the end of the conversation, village residents received booklets with brief information about this disease.

The Kirov Library has organized an exhibition-lecture “Clean lungs – a healthy future.”

The exhibition presents leaflets, brochures, posters about the main sources of infection, factors that contribute to the development of the disease, its symptoms and prevention.

In the Pechishchi library with the participation of medical worker Galimzyanovova N.D. There was a conversation “Tuberculosis. Is it dangerous!".

A meeting was held at the October Library with the village paramedic, Alevtina Vladimirovna Tsyganova.

During the event, Alevtina Vladimirovna held a preventive conversation with residents “Tuberculosis can be prevented, tuberculosis can be cured,” the purpose of which was to attract public attention to the problems of tuberculosis and increase public awareness about the disease and measures for its prevention.

In 2018, tuberculosis prevention activities are held under the motto: “Wanted: leaders for a world free of tuberculosis. Contribute to history. Stop tuberculosis."

Listeners were interested to learn about the history of the origin of this date, which goes back far into the past - to 1882, when Dr. Robert Koch discovered the causative agent of tuberculosis, which was the first step towards diagnosing and treating this disease, as well as about the symbol of this day - chamomile.

Then Alevtina Vladimirovna spoke about the ways of contracting tuberculosis, the general symptoms of the disease, methods of prevention, but the main goal of the conversation is aimed at preventing the disease with an annual fluorographic examination of the chest, which is the only method that allows us to identify initial tuberculosis changes and begin treatment in a timely manner.

The librarian introduced those present to the materials of the exhibition “Your and Our Enemy,” aimed at instilling a healthy lifestyle. Natalya Mikhailovna Artemyeva read lines from her poems, wishing those present health and goodness.

In the Maidan rural library, a health hour “Tuberculosis is a disease that knows no borders” was held with village residents.

Those present learned about the main sources of infection, the factors that contribute to the development of the disease, its symptoms and prevention. Indeed, in recent years there has been an increase in the incidence of tuberculosis, which claims much more human lives than any other infectious disease.

A presentation “Protect yourself from tuberculosis” was prepared for the event and a stand of the same name was set up.

The head of the Yambulatov library held a conversation-dialogue with teenagers “Attention: Tuberculosis”

The librarian told the young people in detail about this disease, introduced them to the concept of “tuberculosis,” its symptoms, possible sources of infection and prevention. Particular attention was paid to the fact that the main reasons for the spread of the disease are bad habits (smoking, alcohol, drug addiction).

It was emphasized that an important role in the prevention of the disease is its timely detection.

At the end, leaflets “Prevention of tuberculosis” were distributed.

Nadezhda Egorova

Report

O celebration of World Tuberculosis Day.

Egorova Nadezhda Gennadievna,

senior teacher

MKDOU BGO Kindergarten No. 16

combined type,

Borisoglebsk, Voronezh region

It's great that everyone in the family is healthy,

Order everywhere: at work, at home.

But one thing torments us all question:

When we forget the disease - tuberculosis?

March 24, 2017 in our kindergarten it was planned celebration of World Tuberculosis Day. In accordance with the plan events were held, aimed at promoting a healthy lifestyle among children, teachers and parents in order to inform about this disease and its prevention.

During the day, the entire kindergarten was covered, all ages groups:

Play activities were organized with children of primary preschool age “Where is the boat going?”, “White daisy is the symbol of the day”, "Journey to the Land of Health", conversations “I breathe, therefore I live”, "The first step on the path to health".

Educational activities of a cognitive nature were organized in groups of senior preschool age "In a healthy body healthy mind", "Health Secrets", "Health Laboratory", "Microbes and Viruses", presentation is a fairy tale "Where does he live? tuberculosis bacillus» , virtual tour "Visiting the Doctor".

Was together with my parents sports activities were held“To love sports is to be healthy”. Also for parents and teachers the nurse was carried out thematic informational conversations "The need for vaccinations" “Being healthy is great”. In all age groups there was placed in the corners for parents information: consultation “The need for active walks in the fresh air”, "Prevention tuberculosis» , health bulletin "How to protect yourself from tuberculosis» , wall newspaper "What do we know about tuberculosis» ,

Reminders and brochures offered "Don't let tuberculosis» , "What do we know about tuberculosis» .

On this day everyone The children presented homemade daisies to employees and parents - a symbol of this day. It is very important that we all together, both adults and children, remember and understand what needs to be done to avoid getting sick.

And the most important thing is to be able to help and support those who need our help.

No matter how the days fly -

Do not regret about anything,

Do a good deed

For myself and people.

Publications on the topic:

Summary of the integrated lesson “Vitamins” in the second junior group as part of World Tuberculosis Day Goals and objectives: Formation of healthy lifestyle skills, development of children's speech and physical activity. Educational objectives: consolidate.

Goal: learn to arrange parts in accordance with the model. Objectives: - to introduce children to their own rights: to a name, to a family, to play.

Report on the event “Relay of Good Deeds” At preschool age, the child is fascinated by the world around him and the task of adults is to support children’s interest in the nature of their native land.

Report on the week “I want to be healthy” Svetlana Sergeevna Khatko According to the plan of events, there was a “Fairy Tale” kindergarten at the MBDOU.

May the sun warm you on this day, May the wind dispel all sorrows, And may flowers bloom in your soul Warmth to everyone, happiness, kindness... What could be more wonderful?

Tuberculosis in the Republic of Belarus over the past two decades continues to be a common disease, causing significant damage to the health of the population and the country's economy.

Thus, the current problems in the fight against one of the most dangerous infectious diseases, which is tuberculosis, require the implementation at the state level of large-scale measures to organize anti-tuberculosis assistance to the population of the republic.

The most important principle of the fight against tuberculosis in our country is the combination of therapeutic and preventive approaches. The embodiment of this combination is the dispensary method. The anti-tuberculosis dispensary organizes and largely implements a set of anti-tuberculosis measures, interacting with treatment and preventive and sanitary-epidemiological institutions, as well as with public organizations. The dispensary analyzes epidemiological indicators and plans the fight against tuberculosis in the service area.

13.1. What indicators are used to characterize the epidemiological situation of tuberculosis in the region?

Population incidence of tuberculosis (primary incidence)

Morbidity (general morbidity)

Mortality

Infectivity

13.2. Under what conditions is a region considered unfavorable for tuberculosis?

· The incidence of tuberculosis is more than 35 per 100 thousand population, or an increasing trend;

· Deterioration of the clinical structure of newly diagnosed patients

· Annual increase in the risk of infection in children;

· Registration of local forms of tuberculosis in children and adolescents.

13.3. What are the components of the global Stop TB initiative?

The global nature of the modern tuberculosis problem is evidenced by expert assessments of the World Health Organization. In 1993, this organization declared a tuberculosis emergency, and in 1995, a new international strategy to combat tuberculosis, called DOTS, began to work. In 2006, the international “Stop TB” strategy came into effect. The goal is to stop the spread of tuberculosis by 2015 and achieve 70% detection of all cases of the disease and 85% cure of patients. Key components of the Stop TB strategy:

· Qualitative expansion and strengthening of the DOTS strategy.

· Combating HIV-associated and multidrug-resistant tuberculosis.

· Promote strengthening of health systems and integration of tuberculosis control into primary health care.

· Strengthening awareness and social support for TB patients.

· Development of scientific research in the field of tuberculosis control.

13.4. What are the priority areas and primary objectives of the State Tuberculosis Program?

The main goal of the State program is to ensure the implementation of citizens' right to health care, enshrined in the Constitution of the Republic of Belarus, by preventing and reducing the spread of tuberculosis infection and improving the epidemic situation.

The primary objectives of the State program are:

· reducing the mortality rate of patients from tuberculosis by 1% per year;

· reduction in the incidence of tuberculosis in the population by 2% per year;

· increase by 2015 the number of actively identified persons with tuberculosis by 5%.

To accomplish these tasks, an action plan for the State Tuberculosis Program for 2010–2014 has been developed, indicating the timing of their implementation, planned expenses, and sources of financing.

13.5. What principles underlie anti-tuberculosis measures in the Republic of Belarus?

The success of the fight against tuberculosis depends on the comprehensive actions of government, public and medical structures. The main principles of the fight against tuberculosis are:

1. State character The fight against tuberculosis is expressed, first of all, in social prevention. All anti-tuberculosis measures are regulated by resolutions and orders of the Council of Ministers and the Ministry of Health of the Republic of Belarus. Medical care for tuberculosis patients is generally available and is provided free of charge. To increase the effectiveness of anti-tuberculosis work, the Council of Ministers of the Republic of Belarus adopted the state program “Tuberculosis” for 2010-2014.

2. Therapeutic and prophylactic principle. Tuberculosis is an infectious disease; it can be combated both in society and at the individual patient level using medical measures. Anti-tuberculosis measures are based on preventing the spread of infection, which is achieved through timely identification, isolation and treatment of the patient, improvement of foci of tuberculosis infection, vaccination and revaccination with BCG, and chemoprophylaxis.

Comprehensive plan to combat tuberculosis

In our country, the task of further reducing the incidence of tuberculosis is solved through a set of measures.

The plan is called comprehensive because it includes a set of measures aimed at both reducing the incidence of tuberculosis and improving working and living conditions and strengthening public health. Both medical and preventive institutions and non-medical institutions and enterprises participate in its implementation. In disadvantaged areas, the veterinary service is also involved in drawing up the plan.

In drawing up a comprehensive plan, the tuberculosis dispensary plays a decisive role as an organizational and methodological center for the fight against tuberculosis.

A comprehensive plan is drawn up for each year in accordance with the five-year development plan for the district (city, region) and is approved by the executive committee of the Council of People's Deputies.

The comprehensive plan includes the following sections of sanitary and health measures: vaccination and revaccination with BCG, chemoprophylaxis, early detection of patients, sanitary and health measures in outbreaks and measures to combat tuberculosis in farm animals and birds. The plan provides for the provision of isolated living space for tuberculosis patients and other issues of social and sanitary prevention of tuberculosis. The sanitary and epidemiological station also takes an active part in drawing up a comprehensive plan on these issues.

The plan also includes X-ray fluorographic examinations of the population to detect tuberculosis, sanitary propaganda, improvement of medical work and diagnostics, personnel training and strengthening of the material base of the anti-tuberculosis service. Comprehensive plans are drawn up taking into account the specific epidemiological situation in the region (city) regarding tuberculosis.

Favorable changes in the epidemiological situation regarding tuberculosis should contribute to the further improvement of anti-tuberculosis measures, but cannot be a reason to weaken them.

COMPREHENSIVE TUBERCULOSIS PLAN

Basic principles of tuberculosis control

State character
Therapeutic and preventive principle (tuberculosis is an infectious disease, the connection between prevention and treatment is very clearly and clearly visible)
Organization of anti-tuberculosis work by specialized anti-tuberculosis institutions and broad participation in this work of all treatment and preventive institutions under the leadership and full responsibility of health authorities.
Medical care for tuberculosis patients is free in most countries.

Structure of the anti-tuberculosis service

The implementation of anti-tuberculosis measures begins at the level of first aid posts, emergency medical clinics, clinics, hospitals by paramedics and general practitioners.

I link – TB doctor at an anti-tuberculosis dispensary (if the population in the area is over 80 thousand inhabitants) or office (in areas with the number of inhabitants less than 80 thousand)
The anti-tuberculosis dispensary is an independent institution. An anti-tuberculosis office is being created at district hospitals (polyclinics).
II link – regional TB dispensary, providing organizational and methodological assistance throughout the region.
III link – Research Institute of Pulmonology and Phthisiology of the Ministry of Health of the Republic of Belarus.

Main sections of the comprehensive plan

I. Measures aimed at reducing the reservoir of tuberculosis infection and preventing its spread among a healthy population:

organization of early and timely detection of tuberculosis by institutions of the general medical network (prophylactic examinations);
BCG vaccination and revaccination;
improvement of foci of tuberculosis infection (housing arrangement);
employment of tuberculosis patients;
sanitary educational work.

II. Organization of diagnosis of tuberculosis and treatment of patients:

hospital treatment;
supervised outpatient treatment;
chemoprophylaxis.

III. Strengthening the material and technical base

I.Social prevention (provided by the state, its economy and reflected in the basic law of the “Constitution”). Includes a set of measures that have a positive impact on the health of the general public and protect the body from tuberculosis.

The state's concern for public health:

– ensuring an adequate standard of living for the population;
– creation of good working conditions in production;
– taking care of people’s proper rest;
– creation of sports facilities
– hardening of the younger generation
– environmental protection

Free treatment of tuberculosis patients (inpatient, outpatient, sanatorium-resort treatment).
Social benefits for tuberculosis patients:

– payment for temporary disability
– bacteria-shedding patients have the right to priority receiving isolated living space.

Special hospitals with compulsory treatment for patients with antisocial behavior who pose an epidemiological danger to others and who evade treatment.

II. Sanitary prevention

A system of sanitary and hygienic measures aimed at preventing infection of healthy people with tuberculosis and combating tuberculosis as an infectious disease.

Timely detection, isolation and treatment of tuberculosis patients
Working in a hotbed of tuberculosis infection
Health education
Control of tuberculosis in farm animals

III. Specific prevention

Activities aimed at increasing human natural resistance to tuberculosis infection.

anti-tuberculosis vaccination and revaccination
chemoprophylaxis

Primary chemoprophylaxis carried out in uninfected individuals from foci of tuberculosis infection who have a negative tuberculin reaction. The goal of primary chemoprophylaxis is to reduce the primary infection and incidence of tuberculosis, to suppress tuberculosis infection in the pre-allergic (incubation) period.

Secondary chemoprophylaxis carried out on infected people. Its goal is to reduce the incidence of tuberculosis in people already infected for the first time (viral), reduce sensitivity to tuberculin in people with hyperergic tuberculin tests and influence exogenous superinfection in people with a positive tuberculin test who are in contact with bacterial excretors.

Anti-relapse chemoprophylaxis carried out for people who have had tuberculosis. Its goal is to prevent the activation of endogenous infection when factors appear that weaken the body’s resistance and during exacerbation of chronic concomitant diseases.

Indications for chemoprophylaxis.

healthy people (adults, adolescents, children) who have contact with the bacteria in the family or apartment;
children and adolescents who are in family contact with a patient with active tuberculosis without bacterial excretion;
livestock farmers working on farms affected by tuberculosis;
children and adolescents who have had contact with bacteria in children's institutions, at the place of study;
children and adolescents with a change in the Mantoux tuberculin test with 2TE PPD-L;
tuberculin-positive children after measles or whooping cough;
children and adolescents with hyperergic reactions to the Mantoux test with 2TE PPD-L (papule diameter 17 mm or more, as well as in the presence of necrosis, vesicles, lymphangitis, regardless of the size of the papule);
adults with post-tuberculosis changes with exacerbation of concomitant diseases (CNLD, diabetes mellitus, peptic ulcer, stage I-II silicosis, alcoholism, during treatment with corticosteroid hormones, immunosuppressants for various nonspecific diseases).

Main indicators of anti-tuberculosis work

1. Population incidence of tuberculosis – the number of people diagnosed with active tuberculosis for the first time in their lives in a given year per 100 thousand population.
2. Soreness – the number of patients with active tuberculosis at the end of the year who are registered, per 100 thousand population.
3. Mortality – the number of patients who died from active tuberculosis per 100 thousand population during the year.
4. Infectivity – the ratio of the number of people infected with tuberculosis to the total number of people who underwent tuberculin tests.

Criteria for a region's disadvantage in terms of tuberculosis

The incidence of tuberculosis is more than 35 per 100 thousand population, or an increasing trend;
Deterioration of the clinical structure of newly diagnosed patients;
Annual increase in the risk of infection in children;
Registration of local forms of tuberculosis in children and adolescents.

Criteria for eliminating tuberculosis

1 bacterial excretor is detected per 10 million population;
Infection rate in children under 14 years of age is less than 1%;
The risk of infection is less than 0.05%.

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“COMPREHENSIVE PLAN TO COMBAT TUBERCULOSIS IN THE REPUBLIC OF KAZAKHSTAN FOR 2014-2020 CONTENTS CHAPTER 1: BASIC PROVISIONS AND INTRODUCTION. »

Process indicators evaluates implementation of activities and measures taken (e.g. number of training modules printed or number of health workers trained) Data analysis, dissemination and use Data collection for all indicators (impact, outcome, output and process) will be carried out using electronic system for collecting individualized data. Managers of the NCTP and all 16 regional vocational schools in the country and the cities of Astana and Almaty are responsible for collecting data, processing it and entering it into the register. A report to the central level will be prepared quarterly. The NCTP will produce an annual report on TB in the country.

All district level vocational schools will use, store and submit information both electronically and in paper form based on the registration system (TB-11 and TB 03) and regularly send reports to the data collection manager NCTP. Data collection will be carried out at 2 levels - regional and NCTP. The flow of information is shown in Fig. 1.

Monitoring and Evaluation Toolkit.HIV, Tuberculosis, Malaria and Health System Strengthening. Part 3:

Tuberculosis. Fourth edition.2011.

Rice. 1. Data flow for impact and outcome indicators Data management department N NCTP Regional level network Paper reporting at the district level (TB-11 & TB03) paper and electronic reporting and reporting systems) implementation of the Comprehensive TB Control Plan in Kazakhstan for 2014-202.

Evaluation of the implementation Indicators of strategic interventions will be used to evaluate the implementation of the lex plan. Three impact indicators are linked to the comprehensive plan's goal (Table 1).

Table 1. Impact indicators for assessing progress in implementing the Comprehensive TB Control Plan for 2014–2020.

Indicator Initial Target Source Frequency N indicator reporting indicator o Year P Indicator 2015 Mortality from NRTB once a year 1,201 8/100000 7.6 TB Morbidity of NRTB once a year 2,201 8 81.7/1000000 75.5 TB Treatment coverage t m NRTB quarterly 3 201 86.9% 90% M/XLDR-TB o 2 100% Detailed characteristics of the task and strategy of ACH interventions are given in Chapter 3 of the Comprehensive Plan. A description of the implementation assessment indicators for strategic interventions is given in Table 2.

Table 2. Indicators for assessing the implementation of strategic interventions (initial and desired indicators, sources and frequency of data collection) Target Initial data Result indicators Indicator Source (category No. indicator indicator) year 2015 Objective 1. Reforming the TB service of Kazakhstan in the civil and penitentiary sectors health care with the expansion of outpatient and inpatient care for patients with TB and M/XDR-TB.

Strategy 1.1. Reform of the anti-tuberculosis service of Kazakhstan in the civil and penitentiary sectors of health care 1.1.1% of reduced NTP Process 2012 10% 30% 40% of beds in vocational schools 1.1.2% of reduced NTP Process 2012 2.5% 10% 20% of Vocational Schools 1.1.3% of reduced NTP Process 2012 20% 40% 60% days of hospitalization Strategy 1.2. Improving the management of TB patients at the outpatient stage of treatment in vocational schools and the PHC NTP network. Output 1.

** 21 - on the development of information materials, 14 - on technical technical training, 140 - on TB in the workplace and 140 - on cascade trainings.

*** 7 - on ToT, 280 - on cascade trainings, 140 - on database management **** since we will have video clips on TV, radio clips, companies and handouts, we can say that 30 will be covered % of the population. This corresponds on average to % of the adult population in populated areas.

Operational research Research is planned for 3 strategic interventions: 2.3.4, 2.3.5. and 3.1.1. The first study aimed to study the effectiveness of methods for early diagnosis of TB among children using tests based on the determination of gamma interferon T SPOT TB (Oxford Immunotec limited Abingdon, UK), isolated from sensitized T lymphocytes, in comparison with Diaskintest® and the Mantoux test 2TE. The second involves examining the reasons for the high rate of adverse outcomes among new TB cases in the prison system.

The third study is to assess the risk of nosocomial TB in vocational schools and primary health care institutions with the preparation of recommendations for further tactics of action.

Operational research was planned by the working group for the development of the CP, taking into account the lack of knowledge of the problem in the country.

The research methodology will be determined by an expert group of local and international specialists for each study separately.

Supervision of M&E activities and quality of data obtained The NCTP is responsible for the implementation of this M&E plan. The NCTP Data Manager is responsible for the overall organization of the registration and reporting system and data collection at all levels.

The M&E team from the NCTP, in collaboration with epidemiologists and HIV experts, will be responsible for regularly checking the quality of registered data and the inclusion of HIV data. The responsibility of the National M&E Group (as an integral part of the NCTP) is to ensure the connection of the national M&E system with the M&E systems of regions and districts. Thus, the M&E systems of regions and districts will achieve harmonization, standardization of data and unification of reporting systems. In addition, if the data is of good quality, the M&E expert group will provide recommendations and further guide efforts at the national level to ensure high-quality implementation of large-scale TB control activities.

The functioning of the M&E Expert Group will contribute to the production of adequate, timely and accurate data that will be reported to national focal points and will serve as a reliable source for the development of national and international registration requirements.

CHAPTER 7. BUDGET PLAN This chapter describes the estimated budget required for the implementation of the Comprehensive Tuberculosis Control Plan in the Republic of Kazakhstan for the period 2014-2020 and includes planned activities, estimated funding for these activities for the implementation period from 2014 to 2016, as well as sources financing. Funding calculations were performed using the WHO TB Control Plan budgeting tool. The calculation used epidemiological actual and prognostic data, the number of patients with TB and M/XDR TB, the number and types of laboratory tests, the names and required quantity of medicines, specialists involved in events, necessary trainings, etc. The calculation was made separately for each unit of each activity and summed up for the total number of planned activities. Expenses were also summed up by task, by year and by source of funding.

The budget plan is based on the operational plan and is closely linked to it. It is also aligned with other components of the Comprehensive Plan and provides detailed information on the financial support for the objectives, strategic interventions and activities identified in the operational plan.

The budget plan is described in detail for the first three years (2014-2016). A review of further funding for the Comprehensive Plan will take place in 2016, when a new budget plan is determined.

In general, for the period 2014-2016. the estimated financing of the Comprehensive Plan activities will be 51.9 billion tenge, with the amount of financing in 2014 amounting to 13.5 billion, and in the next two years – 19.3 billion and 19.1 tenge. The share of funds allocated by the Gobal Fund for the implementation of part of the activities of the Comprehensive Plan will be about 14%.

The budget plan contains information on each strategic intervention and activity requiring funding;

organizations responsible for implementation;

timing and sources of funding.

A detailed description of the budget plan is presented in Excel format in a separate application.

The main directions of the Roadmap for the implementation of the activities of the Comprehensive Plan to Combat Tuberculosis and MDR/XDR TB for 2014-2016 in Kazakhstan Abildaev. - presentation

Presentation on the topic: "The main directions of the Roadmap for the implementation of the activities of the Comprehensive Plan to Combat Tuberculosis and MDR/XDR TB for 2014-2016 in Kazakhstan Abildaev." - Transcript:

1 The main directions of the Roadmap for the implementation of the activities of the Comprehensive Plan to Combat Tuberculosis and MDR/XDR TB for the years in Kazakhstan Abildaev T.Sh. Director of the National Center for Tuberculosis Problems of the Republic of Kazakhstan Astana, 2014

2 Roadmap (task 1 of the Comprehensive Plan) Reform of the anti-tuberculosis service with the expansion of outpatient and inpatient care for patients with TB and M/XDR-TB Action: Reform of the anti-tuberculosis service Reduction of hospital beds Release of staff positions in technical training: Doctors - 87, 5 Nurses - 321.5 Juniors medical personnel - 284.5 Non-medical personnel - 179, buildings will be transferred to the balance sheets of Akimats

3 Roadmap (task 1 of the Comprehensive Plan) Reform of the TB service with the expansion of outpatient and inpatient care for patients with TB and M/XDR-TB Gradual changes in the organizational and legal form of VET in the civil sector with transfer to PCV Development and implementation of mechanisms for differentiated remuneration for VET specialists Improvement of the delivery model medical care for TB patients at the PHC and VET level

4 Roadmap (task 1 of the Comprehensive Plan) Reforming the anti-tuberculosis service with the expansion of outpatient and inpatient care for patients with TB and M/XDR-TB Action: Reforming the financing of the anti-tuberculosis service Development of an improved mechanism for financing VET in order to expand outpatient treatment of patients with tuberculosis, including drug-resistant ones sustainable forms (piloting new methods of financing in Aktobe, Zhambyl, Kyzylorda regions and Astana).

5 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for the diagnosis and treatment of TB and M/XDR TB, strengthening preventive measures, including in the penitentiary sector and among migrants Action: Ensuring access to modern technologies for diagnosing TB and M/XDR TB Introduction of new methods for early diagnosis of TB in children and adolescents - purchase of "Diaskintest" through SK Pharmacy in the amount of 183.2 million t. Purchasing equipment for Express studies for TB and M/XDR TB (XpertMTB/Rif) in laboratories of PTO, PHC and penal system for the amount of 192.7 million t. Purchase reagents for molecular genetic research on TB and M/XDR TB in the laboratories of VET, PHC and penal system (HAIN, XpertMTB/Rif), including service, for the amount of 606.1 million t. d Development and implementation of an EQA system for the laboratory diagnostic methods used for TB and M/XDR TB in the civil and penitentiary health care sectors.

6 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for the diagnosis and treatment of TB and M/XDR TB, strengthening preventive measures, including in the penitentiary sector and among migrants Actions: Ensuring access to modern technologies for diagnosing TB and M/XDR TB Provide bacteriological laboratories of VET with modern bacteriological equipment (BAKTEK, etc.) in the amount of 46.6 million tg Providing reagents and consumables for microscopic and bacteriological studies, DST on solid and liquid media in the civil and penitentiary sectors of healthcare (L-Jensen and Baktek), including maintenance in the amount of 937.4 million tons.

7 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for the diagnosis and treatment of TB and M/XDR-TB, strengthening preventive measures, including in the penitentiary sector and among migrants Action: Develop proposals to expand the existing list of purchased anti-TB drugs with registration and subsequent purchase (linezolid, bedaquiline and other anti-TB drugs) Recruitment of 200 XDR-TB patients for new treatment regimens, including linezolid, bedaquiline, in pilot regions Addition to the order of the Ministry of Health and Social Protection of the Republic of Kazakhstan on the introduction of linezolid, bedaquiline into treatment regimens for M/XDR-TB. Training of personnel in the management of M /XDR-TB with new anti-TB drugs Conducting research on the safety and effectiveness of new anti-TB drugs in pilot regions

8 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for the diagnosis and treatment of TB and M/XDR-TB, strengthening preventive measures, including in the penitentiary sector and among migrants Actions: Step by step introduce individual treatment regimens for M/XDR-TB patients, based on DST data Development of additions to the order on individual treatment regimens for M/XDR TB Introduction of individual treatment regimens for M/XDR TB in pilot regions with subsequent expansion to the entire republic. Actions: Step by step introduce an outpatient treatment model for TB and M/XDR-TB patients with psychosocial support throughout the country. Creation of a working group to develop Regulations on outpatient treatment and psycho-social support for M/XDR-TB patients.

9 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for diagnosing and treating TB and M/XDR-TB, strengthening preventive measures, including in the penitentiary sector and among migrants Actions: Providing social assistance to patients with TB and M/XDR-TB in at the outpatient stage by monthly transfer to individual card accounts of money at the cost of living to calculate basic social payments. It is planned to provide assistance to patients in the amount of 1,460.3 million tons. Actions: Providing monthly social assistance to patients with TB and M/XDR-TB at the outpatient stage through other mechanisms Food packages, compensation for transportation costs, hot meals, etc. will be provided to tuberculosis patients undergoing outpatient treatment in the amount of 1,958.5 million t.

10 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for the diagnosis and treatment of TB and M/XDR TB, strengthening preventive measures, including in the penitentiary sector and among migrants Actions: Develop and implement new methods of surgical treatment of pulmonary and extrapulmonary tuberculosis . Development of methodological recommendations for collapse, surgical treatment of patients with XDR-TB, intraoperative catheterization of destruction in osteoarticular TB. Development of an interdepartmental plan for the provision of medical care, including surgical care, to patients with TB and M/XDR TB in the penal system. Actions: Provide TB and M/XDR-TB patients at the outpatient level with methods for diagnosing adverse reactions of anti-TB drugs, symptomatic and pathogenetic agents. For patients with tuberculosis, symptomatic and pathogenetic agents will be purchased in the amount of 639.5 million t.

11 Roadmap (task 2 of the Comprehensive Plan) Improving the availability of modern effective technologies for diagnosing and treating TB and M/XDR-TB, strengthening preventive measures, including in the penitentiary sector and among migrants Actions: Develop methods for managing anti-TB drugs Creation of a working group for the development and approval of the Guidelines Resolving the issue of registration of pediatric dosages of anti-TB drugs Ensuring full coverage of tuberculosis chemoprophylaxis for contact children.

12 Roadmap (task 3 of the Comprehensive Plan) Strengthening infection control systems, monitoring and evaluation of anti-tuberculosis measures, including in the penitentiary sector Actions: Develop Regulations on hospitalization and isolation of TB patients in the civil and penitentiary health sectors in accordance with the infectious status. Install an effective mechanical ventilation system in high-risk VET premises in the civil and penitentiary healthcare sectors in the amount of 1.103.7 million tg. Provide medical workers of the VET with means of protection and control of proper use in the amount of 1.108 million tg.

13 Roadmap (task 3 of the Comprehensive Plan) Strengthening infection control systems, monitoring and evaluation of anti-tuberculosis activities, including in the penitentiary sector Action: Create a unified electronic database of TB patients in the civil and penitentiary health care sectors. Phased provision of Internet communications and computers to bacteriological laboratories, pharmacies and organizational and methodological departments of VET, including penal institutions. Drawing up design documentation for the installation/reconstruction of mechanical ventilation systems of PHE and approval at the level of the Ministry of Internal Affairs of the Republic of Kazakhstan, akimats of the regions and the cities of Astana and Almaty. Introduction of an electronic model for predicting the prevalence of TB and MDR-TB Introducing into the VET staff responsible specialists for the work of the NRTB and the M&E group for the implementation of anti-tuberculosis measures.

14 Roadmap (task 4 of the Comprehensive Plan) Strengthening interdepartmental and intersectoral cooperation to combat TB Action: Ensuring control of TB/HIV in the country Development and approval of protocols for the management of patients with TB/HIV, TB/HIV/IDU, M/XDR-TB/ HIV Full coverage of chemoprophylaxis with isoniazid for PLHIV in the civil and penitentiary system Full coverage of antiretroviral therapy for patients with TB/HIV co-infection in the civil and penitentiary system Action: Involvement of NGOs in the implementation of anti-tuberculosis measures Organization of pilot primary health care centers to introduce social support programs for high-risk patients (IDUs, prisoners , PLHIV) Allocation of grants for NGOs on innovative approaches to increasing adherence to TB treatment in outpatient settings.

15 Roadmap (task 4 of the Comprehensive Plan) Strengthening interdepartmental and intersectoral cooperation to combat TB Action: Providing TB care to internal and external migrants Creation of a working group to develop guidelines for providing TB care to migrants Development of indicators for TB in migrants and their integration into the standard system M&E in the country. Creation of a medical and social fund for the treatment and diagnosis of TB of undocumented migrants and training of a national consultant Providing a social package for migrants at the outpatient level of treatment. Development of information and educational materials focused on the specific needs of migrants.

16 Indicators for the implementation of the Comprehensive Plan to Combat TB in Kazakhstan for the years (1) Reduction in TB incidence to 55.5 per 100 thousand population. Decrease in Mortality from TB to 3.8 per 100 thousand population. Reduction of beds in PTO up to 35% Reduction of days of hospitalization up to 55% TB and M/XDR-TB patients on full outpatient treatment – 50% Coverage of target population groups with molecular genetic tests (GenXpert) up to 100% Coverage of TB patients with DST up to 100% Treatment coverage patients with MDR-TB with second-line drugs and patients with XDR-TB with third-line drugs up to 100% Success rate of treatment of patients with MDR-TB up to 75%

17 Indicators for the implementation of the Comprehensive TB Control Plan in Kazakhstan for the years (2) Coverage of social support (at least 1 time per month) for tuberculosis patients on outpatient treatment up to 90% Percentage of tuberculosis patients with incomplete treatment released from MLS and taken to remote care in civil sector - 90 Coverage of PLHIV with isoniazid chemoprophylaxis up to 95% Coverage of TB/HIV patients with preventive treatment with cotrimaxozole up to 100% ART coverage of TB/HIV patients up to 100% Number of NGOs involved in NTP - 15 Number of migrants screened for TB -

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