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Extrapulmonary TB in Belarus A.Skrahina RSPC of Pulmonology and Tuberculosis, Minsk, Belarus

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Extrapulmonary TB in Belarus

A.Skrahina

RSPC of Pulmonology and Tuberculosis, Minsk, Belarus

Page 2: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

NRL TB units

2nd Level Laboratory

M&E Dep-t

Republican TB Hospital

1st Level Laboratory

3rd Level Laboratory

Oblast TB Dispens.

Regional TB Dispens.

SNRL

ECDC

TB service in Belarus

Page 3: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

TB incidence (per 100 000 population), trends, 2002-2012

Page 4: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

TB forms distribution (%), trends, 2002-2012

Page 5: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Bacteriological confirmation (%) by all methods, trends, 2002 – 2012

Page 6: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Proportion of MDR-TB among bacteriologically confirmed new TB cases (%), trends, 2010-2012

Page 7: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Proportion of MDR-TB among bacteriologically confirmed relapse cases (%), trends, 2010-2012

Page 8: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Major site of EPTB, trends, 2009-2012

0,7

40,7

7,95,816,3

6,7

19,1

2,62010

Page 9: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

EPTB Pulmonary TB

Male/female distribution (%) among new cases, trends, 2010 – 2012

Page 10: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Male/female distribution (%) among relapse cases, trends, 2010 – 2012

EPTB Pulmonary TB

Page 11: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Proportion of HIV co-infected among new cases (%), trends, 2010 – 2012

EPTB Pulmonary TB

Page 12: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Proportion of HIV co-infected among relapse cases (%), trends, 2010 – 2012

EPTB Pulmonary TB

Final outcomes (%): HIV-negative new TB cases, trends, 2010 - 2011

Pulmonary TB

EPTB

Final outcomes (%): HIV-negative relapse cases, trends, 2010 - 2011

Pulmonary TB

EPTB

Final outcomes (%): HIV-positive new TB cases, trends, 2010 - 2011

Pulmonary TB

EPTB

Final outcomes (%): HIV-positive relapse cases, trends, 2010 - 2011

Pulmonary TB

EPTB

• Absence of national EPTB guidelines

• No collaboration between TB specialists and other specialists: – TB is not considered in the differential diagnosis

– Late diagnostics

– Under diagnostics

– Over diagnostics (inability to exclude TB)

– Incidental diagnostics

– Samples from non-TB hospitals are not send to TB lab

• Low level of bacteriologic confirmation: – Unknown drug resistance/susceptibility profile

– Inadequate chemotherapy

Challenges

Page 18: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Pleural TB

Page 19: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Liver and spleen TB

Page 20: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Liver and spleen TB

Page 21: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Spine TB

Page 22: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

LN TB

Page 23: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

LN TB

Urogenital TB

CNS TB

• Henadz Hurevich – director

• Andrey Astrauko – deputy director, monitoring & evaluation department

• Anna Belko – sr. researcher of monitoring & evaluation department

RSPC of Pulmonology and Tuberculosis, Minsk, Belarus

Acknowledgement

Page 27: Extrapulmonary TB in Belarus - Stop TBC · Urogenital TB . CNS TB • Henadz Hurevich – director • Andrey Astrauko – deputy director, monitoring & evaluation department •

Thanks

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