ABSTRACT
Approaches to assessing the role of health care in reducing mortality in Russia from the standpoint of controlling manageable causes are discussed. Based on the concept of avoidable mortality, trends in regional variability of mortality, the nosological and gender characteristics for the years 2000-2019 have been analyzed. The patterns revealed indicate the following: a significant contribution of medicine and health care to the decrease in the premature reduction in the life expectancy of the population, the expediency of developing a regional classification of the list of avoidable causes of mortality, and the decisive role of prevention and the improvement of the lifestyle of the population of young and middle ages in the past two decades against the background of a slow increase in the capacity of clinical medicine in the diagnostics and treatment of diseases.
ABSTRACT
Leprosy was modeled in an experiment on BALB/c, BALB/cNude, CBA, and C57BL/6ТNF-/- mice using three Mycobacterium leprae strains obtained from patients with a diagnosis of A30 according to ICD-10 from different regions of the Russian Federation. Proliferation of M. leprae of the used strains showed a temporal-quantitative dependence on the used mouse line. CBA and BALB/cNude mice were optimal for strain R and BALB/c and BALB/cNude lines were optimal for strain I. BALB/cNude mice infected with strain I had low lifespan. M. leprae strain M showed low proliferation activity in BALB/cNude and C57BL/6ТNF-/- mice.
Subject(s)
Adaptive Immunity , Immunity, Innate , Leprosy/immunology , Longevity/immunology , Mycobacterium leprae/pathogenicity , Tumor Necrosis Factor-alpha/immunology , Animals , DNA, Bacterial/genetics , Disease Models, Animal , Host Specificity , Humans , Leprosy/genetics , Leprosy/microbiology , Leprosy/pathology , Longevity/genetics , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Mice, Inbred CBA , Mice, Knockout , Mice, Nude , Mycobacterium leprae/genetics , Mycobacterium leprae/growth & development , Mycobacterium leprae/immunology , Tumor Necrosis Factor-alpha/deficiency , Tumor Necrosis Factor-alpha/geneticsABSTRACT
Certain level of new registered cases of leprosy in a number of endemic countries in the world, as well as growing rate of transboundary migratory flows, raise the issue of effective diagnosis of this disease in countries with sporadic incidence of leprosy, including the Russian Federation. The purpose of the study was to develop a highly sensitive PCR test for detecting the genetic material of Mycobacterium leprae and to compare the test robustness and sensitivity with the commercially available Leprosy Genesig Standard Kit (Primerdesign Ltd., UK). The proposed approach uses real time PCR of non-coding repeating element RLEP, unique for the M. leprae genome, using TaqMan probe. The high test specificity was shown using the reference DNA samples of pathogenic and conditionally pathogenic mycobacterium, as well and its comparison with single-copy genes of M. leprae (rrs, fbp, MntH) PCR detection. The use of a commercially available test system based on the single-copy rpoB gene detection provided 59.4% sensitivity to the detection of M. leprae in the clinical material, while the application of the developed approach increased this index to 96.8%. The developed PCR diagnostics test of leprosy is submitted for state clinical approval process, whereupon the practical use of the test diagnostics allows solving a wide range of tasks to identify and confirm new cases of leprosy, and monitoring both the effectiveness of leprosy treatment, and epidemiological (including transboundary) the spread of the disease.
