[Implication of laparoscopy in diagnostics of genital tb among women through cytohistological testing of bioptic specimen].

Diagnostics of genital TB among women is a serious challenge because of the absence of specific clinical manifestation and difficulty to obtain material for bacteriological verification of the pathogen. All the cases with ascites and masses in pelvic cavity must undergo thorough testing to exclude tuberculosis. The present article describes 14 suspect cases of genital TB, where along with the mandatory clinical diagnostic studies (including PCR of ascites and bacteriological testing for TB, also on carcinoma of CA-125 ovary) they have conducted laparoscopy, with further cytological and bacteriological testing of bioptic sample. This method allowed us to diagnose genital and abdominal tuberculosis among women in 85,7% of cases through cytologic and histologic testing and to exclude ovarian carcinoma. Effectiveness of laparoscopy has been confirmed in diagnostics of genital and abdominal TB.

Outcomes among tuberculosis patients with isoniazid resistance in Georgia, 2007-2009.

BACKGROUND: The optimal management strategy for patients with isoniazid (INH) monoresistant forms of tuberculosis (TB) has been widely debated. The current daily 9-month regimen of rifampin, pyrazinamide and ethambutol was established based largely on trials in settings with low TB rates and low rates of drug resistance. OBJECTIVE: To explore the outcomes of patients with INH-monoresistant TB in the country of Georgia, a setting with both high TB rates and drug-resistant forms of the disease. METHODS: Retrospective record review of all patients diagnosed with smear-positive pulmonary TB resistant to either INH or INH+SM (streptomycin) in Georgia between 2007 and 2009. RESULTS: Of 8752 patients with pulmonary TB registered in Georgia, 909 were found to have INH or INH+SM resistance. Treatment outcomes were relatively poor in this group, with only 71% treatment success. Outcomes were significantly worse among patients with older age and a history of previous treatment. CONCLUSIONS: INH or INH+SM resistance in pulmonary TB patients in Georgia is common. The low rates of treatment success suggest the need for an improved treatment regimen for patients with resistance to these first-line drugs; this need is particularly pronounced among the subset of patients with a history of previous treatment.

Prevalence and risk factors for drug resistance among hospitalized tuberculosis patients in Georgia.

BACKGROUND: Tuberculosis (TB) control in Georgia follows the World Health Organization-recommended DOTS strategy, and has reached global TB control targets in the treatment of susceptible TB; however, the management of drug-resistant forms of TB still represents a serious problem. A countrywide drug resistance survey (DRS) found that the prevalence of multidrug-resistant TB (MDR-TB) was respectively 6.8% and 27.4% in new and previously treated TB cases. OBJECTIVE: To determine the prevalence of and risk factors for drug resistance among TB patients to improve case management and control of drug-resistant TB. METHODS: Extensive social, clinical and bacteriological data were collected from patients hospitalized at the National Centre for Tuberculosis and Lung Diseases, Georgia, between 2005 and 2007. RESULTS: Of 605 patients, resistance was observed in 491 (81.2%); MDR-TB was found in 261 (43.1%; 51/222 [23%] new cases and 210/383 [55%] previously treated cases), monoresistant TB in 130 (21.5%), poly-resistant TB in 67 (11.1%) and extensively drug-resistant TB in 33 (5.5%). Female sex, living in the densely populated capital, family TB contact and previous TB treatment were associated with risk of MDR-TB. CONCLUSIONS: These findings confirm the necessity of improving infection control measures and of standardized treatment for drug-resistant TB patients.

[For periodization of history of fight against TB in Georgia].

Evolution of TB programs indicates the importance of analysis of existing experience and reasons of failure in planning of TB strategy for future. In spite of existing scientific researches in the field of history of fight against TB in Georgia, it turned out that the question is not mastered perfectly, various periods are not sorted out and the comparative analysis is not made. On account of this, a request was raised to elaborate a new periodization. The aim of our research is to work out a new variant of periodization of history of fight against TB in Georgia. Epidemic, literary and the official statistical data were worked out by the methods of historical analysis and standardization. According to the research, it turned out that the correlation exists between social -political state and the spreading of TB, which was reflected in our "step" pattern. It means to serve as criteria of spreading of tuberculosis and TB strategy. Concerning these criteria a new variant of periodization was elaborated and the separate stages were compared. It gives us opportunity to determine effective methods and measures and they should be envisaged in the condition of realisation DOTS strategy in Georgia.