[The epidemiological situation of urogenital tuberculosis in Siberia and the Far East].

ABSTRACT

INTRODUCTION: Tuberculosis remains one of the most important problems of our time. Late diagnosis of urogenital tuberculosis (UGT) results from a lack of a clinician awareness, paucity of pathognomonic symptoms and suboptimal therapy for urinary tract infections while UGT often manifests under their disguise. AIM: To determine the incidence of urogenital tuberculosis and its structure in an epidemiologically unfavorable region. MATERIAL AND METHODS: The study compared the temporal changes in the structure of UGT morbidity from 1999 to 2015 in the Siberian and Far Eastern Federal Districts and analyzed outpatient medical records of 456 UGT patients. RESULTS: The highest (46%) proportion of UGT in the structure of extrapulmonary disease was found in 2003, the lowest (22.9%) in 2014. According to outpatient medical records, the proportions of patients with stage 1, stage 2 and cavernous forms of nephrotuberculosis ranged from 21.2 to 37%, 26 to 53.5% and 21.6 to 37%, respectively. The incidence of prostate tuberculosis ranged from 0 in 2003 and 7.1% in 2008 to 54.2% in 2013, averaging to 33.9%. CONCLUSIONS: Currently, it is impossible to estimate the true prevalence of UGT, we can only speak about the detection rate. Every fourth UGT patient was under the medical supervision with a wrong diagnosis for 5 or more years. The proportion of UGT in the structure of morbidity from all forms of extrapulmonary TB reached a minimum (22.9%) in 2014 but went up again. Introducing new technologies has led to an improvement of bacteriological verification of UGT and increased prostate tuberculosis detection rate to 35.7%.