standard progress report 2010 - nsc · secvla da misi orientireba tbilisis samizne mosaxleobasi...

Standard Progress Report

GEO1R21A – Breast and Cervical Cancer Screening Programme

2010

GEO1R21A/Support to Breast and Cervical Cancer prevention

UNFPA standartuli angariSi proeqtis mimdinareobis Sesaxeb 2011 წელი

GEO2R21A ZuZusa da saSvilosnos yelis kibos prevenciis mxardaWeris programa

Standard Progress Report GEO1R21A – Breast and Cervical Cancer Screening Programme

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UNFPA Country Office in Georgia

UN House, ; Fax: (995 32) 2502 71/72

sarCevi Sesavali I. mizani

II. resursebi

III. Sedegebi IV. finansuri implementacia

V. momavali samuSao gegma


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qveyana: saqarTvelo

saangariSgebo periodi: 2011 wlis 10 ianvari – 31 dekemberi programis komponenti – reproduqciuli janmrTeloba

proeqtis saidentifikacio monacemebi (gamoiyeneT ATLAS kodi): GEO2R21A

proeqtis saxelwodeba da saidentifikacio nomeri (Tanadafinansebis mqone proeqtebisaTvis) : GEO2R21A / ZuZusa da saSvilosnos yelis kibos skriningis programa

Tanadamfinansebeli donorebi: Tbilisis municipalitetTan arsebuli jandacvis, kulturisa da socialuri sakiTxebis departamenti/ gaeros mosaxleobis fondi (UNFPA)

programis komponentis xelmZRvaneli: Sromis, janmrTelobis da socialuri dacvis saministro

Semsrulebeli partniorebi: erovnuli skrining centri, UNFPA

I. შესავალი

partnioruli programa Tbilisis municipalitetis jandacvisa da socialuri daxmarebis departamentsa da UNFPA/saqarTvelos Soris, romelic iTvaliswinebs reproduqciuli traqtis kibos prevencias da adreul gamovlenas, amoqmedda 2006 wels TbilisSi. proeqtis ganxorcielebis Sedegad miRebuli monacemebisa da gamocdilebis analizis safuZvelze 2008 wlis dasawyisSi moxda proeqtis dizainis Secvla da misi orientireba Tbilisis samizne mosaxleobaSi ZuZusa da saSvilosnos yelis kibos skriningze. aRniSnuli proeqtis gansaxorcieleblad SerCeuli iqna erovnuli skrining centri. proeqti warmoadgens mniSvnelovan intervencias, romelic mosaxleobas uzrunvelyofs meti xelmisawvdomobiT reproduqciuli janmrTelobis maRalxarisxiani momsaxurebisadmi. proeqti xorcieldeba saqarTvelos pirveli ledis patronaJiT. es novatoruli proeqti erT-erTi pirvelia msgavs proeqtebs Soris, romelic xorcieldeba aRmosavleTi evropisa da centraluri aziis qveynebSi. igi miznad isaxavs reproduqciuli sistemis kibos adreul etapze gamovlenis maCveneblebis gazrdas, rac Tavis mxriv ganapirobebs am daavadebebiT gamowveuli adreuli sikvdilianobis Semcirebas qalTa Soris. am miznebis miRwevis gzebs warmoadgens samizne asakis qalebisaTvis ZuZusa da saSvilosnos yelis kibos skriningisadmi Tanasworuflebiani xelmisavdomobis uzrunvelyofa da imavdroulad programis menejmentis, momsaxurebis miwodebis, monitoringis, Sefasebisa da angariSgebis saTanado standartebis SenarCuneba. proeqtis mniSvnelovanma miRwevebma qalTa avadobisa da sikvdilianobis Semcirebis saqmeSi safuZveli Seqmna imisaTvis, raTa qveynis xelisuflebas mieRo gadawyvetileba proeqtis erovnul doneze gafarToebis Sesaxeb. 2009-2010 wlebSi ZuZusa kibos skriningis programis ganxorcieleba daiwyo aseve saqarTvelos oTx regionSi. daavadebaTa kontrolisa da sazogadoebrivi jandacvis erovnuli


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centris programis meSveobiT 2011 wlis ivnisidan kibos skriningis programa sruli moculobiT (ZuZus, saSvilosnos yelis da swori nawlavis kibos skriningi da prostatis kibos riskis marTva) xelmisawvdomi gaxda saarTvelos mTeli mosaxleobisaTvis. programas axorcielebs erovnuli skrining centri.

II. მიზანი UNDAF gamosavali:: gaizarda socialurad daucveli mosaxleobis xelmisawvdomoba xarisxiani samedicino momsaxurebis, ganaTlebis, iuridiuli daxmarebisa da sxva umniSvnelovanesi socialuri samsaxurebisadmi.

2008-2013 UNFPA SP gamosavali 2.2: gaizarda dedaTa jandacvis samsaxurebisadmi xelmisawvdomoba da maTi gamoyeneba, rac miznad isaxavs dedaTa avadobisa da sikvdilianobis Semcirebas, maT Soris riskis Semcveli abortebis prevencias da maTi garTulebebis marTvas. mosalodneli gamosavali: gaizarda socialurad daucveli mosaxleobis jgufebis xelmisawvdomoba xarisxiani samedicino momsaxurebis, ganaTlebis da sxva umniSvnelovanesi socialuri samsaxurebisadmi. mosalodneli Sedegi:

1.2: xelmisawvdomobis gaumjobeseba sqesobrivi da reproduqciuli jandacvis samsaxurebisa da genderuli informaciisadmi, gansakuTrebiT ki mosaxleobis ukiduresad daucveli jgufebisaTvis. Semsrulebeli partniorebi: erovnuli skrining centri, UNFPA

III. რესურსები proeqtis ganxorcielebis saerTo biujeti 2011 wlisaTvis Seadgenda 828,397.70 aSS dolars dafinansebis wyaro: UNFPA HSAD/sxva donorebi ZiriTadi resursebi – 170,000 aSS dolari

ara-ZiriTadi resursebi (HSAD GEA03) – 658,397.70 aSS dolari


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IV. შედეგები

proeqtis menejmenti

proeqtis menejmentis gundi warmodgenili iyo erovnuli skrining-centris direqtoriT, UNFPA-s mier daqiravebuli proeqtis konsultantiT, adgilobrivi konsultantiT samedicino epidemiologiis sferoSi da sainformacio teqnologiebis specialistiT. monitoringis asistenti, rogorc erToblivi sainspeqcio jgufis wevri, uzrunvelyofda proeqtis ganxorcielebis yovelTviur monitorngs, proeqtis farglebSi gamokvleuli qalebis Semdgom meTvalyureobas da momxmarebelTa kmayofilebis kvlevis Catarebas. UNFPA-s saqarTvelos ofisi uzrunvelyofda proeqtis zogad marTvas da teqnikur mxardaWeras.

UNFPA-s xelSewyobiT regularulad tardeboda proeqtis sameTvalyureo komitetis sxdomebi. komitetis SemadgenlobaSi Sedian saqarTvelos pirveli ledi, proeqtis donorebi, menejmentis gundi da Semsrulebeli partniorebi. sxdomebi miznad isaxavda proeqtis ganxorcielebis mdgomareobis Seswavlas, miRwevebisa da problemebis ganxilvas da Semdgomi RonisZiebebis SeTanxmebas. garda amisa, proeqtis mimdinareoba ramdenjerme iqna ganxiluli Sromis, janmrTelobisa da socialuri dacvis saministrosTan (Sjsds) arsebuli reproduqciuli janmrTelobis erovnuli sabWos sxdomebze.

saqarTvelos regionebSi saSvilosnos yelis kibos skriningis programis danergvis mxardaWera

UNFPA-saqarTvelos ofisi proeqtis amoqmedebisTanave uWerda mxars saSvilosnos yelis skriningis programis danergvas mTeli qveynis masStabiT. UNFPA-s mxardaWeriT 2010 wels momzadda da CNN–s arxze naCvenebi iqna specialuri videorgoli, romelSic yuradReba gamaxvilebuli iyo dedaqalaqis farglebs gareT, regionebSi, saSvilosnos yelis kibos skriningis programisadmi xelmisawvdomobis gazrdis mniSvnelobaze.

saSvilosnos yelis kibos prevenciis kvireulis periodSi, romelic saqarTveloSi farTod aRiniSna 2011 wlis ianvarSi, UNFPA-s organizebiT Catarda mxardaWeris specialuri RonisZieba, romlis drosac moxda UNFPA-s xelSewyobiT momzadebuli da Sjsds-s mier damtkicebuli saSvilosnos yelis kibos skriningisa da diagnostikis gaidlainebis prezentacia. Sexvedras eswrebodnen saqarTvelos pirveli ledi, parlamentis Tavmjdomaris moadgileebi, Sromis, janmrTelobisa da socialuri dacvis ministri, daavadebaTa kontrolisa da sazogadoebrivi jandacvis centris direqtori, aRniSnuli sferos wamyvani specialistebi da saerTaSoriso da donori organizaciebis warmomadgenlebi. UNFPA-m kidev erTxel aRniSna regionebSi saSvilosnos yelis kibos skriningis programis danergvis mniSvneloba, rac miznad isaxavs mTels qveyanaSi samizne asakis qalebisaTvis


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sasicocxlo mniSvnelobis mqone samsaxurebisadmi xelmisawvdomobis gazrdas. unda aRiniSnos, rom mTavrobam miiRo gadawyvetileba 2011 wlis ivnisidan ganaxorcielos skriningis programis danergva mTeli qveynaSi.

erovnuli SesaZleblobebis Seqmna ZuZusa da saSvilosnos yelis kibos skriningis programis dagegmvisa da ganxorcielebisaTvis

UNFPA-s erT-erT prioritets warmoadgens ZuZusa da saSvilosnos yelis kibos skriningis programisaTvis strategiuli dagegmvis, klinikuri marTvis, ganxorcielebisa da xarisxis uzrunvelyofis erovnuli SesaZleblobebis Seqmna. am TvalsazrisiT saangariSi periodSi Catarda ramdenime mniSvnelovani RonisZieba:

1. saqarTveloSi skriningis erovnuli programis dagegmvisa da ganxorcielebis strategiuli rekomendaciebis SemuSavebisasTan dakavSirebuli saWiroebebis dakmayofilebis mizniT, romlebic adgilobrivi partniorebis mier iqna gamovlenili, UNFPA-m am procesSi CarTo evropis wamyvani teqnikuri dawesebulebebi da eqspertebi.

aRniSnuli iniciativis farglebSi saqarTvelos wamyvan partniorTan, saSvilosnos yelis kibos evropis asociaciasTan erTad 10-11 oqtombers daavadebaTa kontrolis erovnul centrSi Catarda saqarTveloSi kibos skriningis danergvis strategiuli dagegmvisadmi miZRvnili Sexvedra. masSi monawileobdnen daavadebaTa kontrolis erovnuli centris, skriningis erovnuli centrisa da Sjsds-s xelmZRvaneli da teqnikuri personali. Sexvedraze moxsenebiT gamovida poloneTSi ZuZusa da saSvilosnos yelis kibos skriningis programis damaarsebeli da xelmZRvaneli profesori marek spaZinski. man damswreebs gauziara poloneTis, anu im qveynis gamocdileba, romelic mraval aspeqtSi identuria saqarTveloSi arsebuli mdgomareobisa. Sexvedraze ganixiles jandacvis sistemis mimdinare reforma, paralelurad moxda kibos skriningisa da prevenciis kontrolis amocanebis ganxilva da daxvewa. miRweuli iqna SeTanxmeba saqarTveloSi kibos skriningis danergvis rekomendaciebis ZiriTad aspeqtebTan dakavSirebiT. SemuSavda saboloo angariSis pirveli samuSao versia, romelic ganxiluli iqneba daavadebaTa kontrolis centrTan da Sjsds-sTan erTad da amis Semdgom miiRebs saboloo saxes.

2. skriningis erovnuli centris orma ginekolog-kolposkopistma did britaneTSi gaiara kolposkopiisa da saSvilosnos yelis paTologiebis evropis federaciis mier organizebuli orkviriani saswavlo kursi, ramac xeli Seuwyo kolposkopiaSi maTi Teoriuli codnis srulyofasa da praqtikuli unar-Cvevebis gaumjobesebas. saqarTvelodan wargzavnilTa mgzavrobis xarjebis dafinanseba uzrunvelyo gaeros mosaxlebis fondma (UNFPA).

3. saSvilosnos yelis kibos evropis asociaciasTan da UICC (kibos saerTaSoriso kontrolis kavSiri) TanamSromlobis farglebSi gasul wels UNFPA-m Caatara pap-testiT citologiuri diagnostikis xarisxis monitoringi. kerZod, 2010 wels italiaSi, xarisxis kontrolis or laboratoriaSi, rejio emiliasa da viarejioSi, romlebic momsaxurebas uweven mosaxleobaze dafuZnebul skriningis programebs italiaSi, Catarda saqarTveloSi saSvilosnos yelis citologiuri kvlevis damoukidebeli


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Sefaseba. aRniSnuli RonisZieba miznad isaxavda TbilisSi mimdinare skriningis programaSi monawile citologiuri laboratoriebis mier Sesrulebuli gamokvlevebis Sefasebas da saWiroebebsi gamovlenas specifikuri unar-Cvevebis gaumjobesebisaTvis.

Catarebuli Sefasebis safuZvelze, Tbilisis

laboratoriebis xelmZRvaneli ori citopaTologisaTvis, 2011 wels SemuSavda

meTodologiuri programebi. isini saswavlo kursis gasavlelad gagzavnili iqnen rejio emilias laboratoriaSi. aRniSnuli programa SemuSavebuli iqna, erTis mxriv, Sefasebis Sedegad gamovlenili specifikuri

problemebis aRmosafxvrelad, xolo, meores mxriv, adgilobrivi citopaTologebisaTvis xarisxis kontrolis dasavleTevropuli tipis laboratoriebis funqcionirebis Sesaxeb codnis misaRebad.

saswavlo kursis dasrulebis Semdeg, 2011 wlis 8-14 seqtembers TbilisSi Catarda ginekologiuri citopaTologiis seminari. misi organizatorebi (kibos saerTaSoriso kontrolis kavSiris mxardaWeriT) iyvnen sami italieli eqsperti: paTologiebis kvlevebis wamyvani konsultanti, profesori cezare jentili; paTanatomiisa da citopaTologiis profesori luiji di bonito da q-ni lara bosko, diagnostikuri momsaxurebis swavlebis programis xelmZRvaneli da paTologiebis kvlevis samsaxuris teqnikuri koordinatori. am seminarSi monawileobda saSvilosnos yelis skriningis erovnul programaSi CarTuli Tbilisisa da regionaluri centrebis laboratoriebis 15 citopaTologi.

seminarze miRweuli iqna Semdegi Sedegebi:

a. italielma kolegebma sakuTari codna gauziares qarTveli citopaTologebs, romlebic monawileobas miiReben saqarTveloSi saSvilosnos yelis skriningis programis farTod danergvaSi;

b. Sesabamisi safuZveli Seiqmna TbilisSi momuSave ori citopaTologis dargis wamyvan specialistebad warmosaCenad, rac saSualebas miscems maT warmarTon aRniSnuli programis qveynis masStabiT gafarToebisaTvis saWiro saswavlo procesi;

g. daixvewa seminaris formati da saswavlo masalebi, rac SemdgomSi modelis saxiT iqneba gamoyenebuli saqarTveloSi seminarebis Casatareblad.

daigegma citologiuri gamokvlevebis damoukidebeli gadamowmebis ganmeorebiT Catareba, rac mogvcems miRweuli warmatebebis dazustebisa da Sefasebis saSualebas.


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4. proeqti aqtiurad TanamSromlobda saqarTvelos onkoginekologiis sazogadoebasTan da Tavisi wvlili Seitana aRniSnuli sazogadoebis mier baTumSi 24-26 ivniss Catarebul saSvilosnos yelis paTologiis saerTaSoriso konferenciaSi. kerZod, UNFPA-s mxardaWeriT saSvilosnos yelis kibos skriningis programaSi CarTulma 15 ginekologma Tbilisidan da regionebidan, miiRo ra monawileoba konferenciis muSaobaSi da evropis kolposkopistTa federaciis (EFC) eqspertebis mier Catarebul kolposkopiis saswavlo kursebSi, aimaRla sakuTari codna da srulyo Tavisi unar-Cvevebi.

5. ZuZus kibos skriningis programis klinikuri servisebis xarisixis gaumjobesebisa da xarisxis uzrunvelyofis meqanizmebis SemuSavebis mizniT holandiel eqspertebTan da ZuZus kibos skriningis saswavlo centrTan (niderlandebi) damyarda partnioruli urTierTobebi, rac miznad isaxavs a) saqarTveloSo mamografiuli skriningisa da diagnostikis sizustis Sefasebas da Sedegebis Sedarebas dasavleT evropaSi moqmed standartebTan da b) ZuZus kibos skriningis erovnuli programis xarisxis uzrunvelyofis meqanizmebis SemuSavebas.

TanamSromlobis farglebSi skriningis erovnuli centris, tatiSvilis samedicino centris da Tbilisis onkologiis centris arqivebidan randomizirebulad da proporciulad SerCeuli iqna 2010 wlis 1 noembridan 2011 wlis 30 aprilamde eqvsTvian periodSi gakeTebuli 350 mamograma. mamogramebi pacientTa saidentifikacio monacemebis gareSe, magram Sesabamisi klinikuri informaciiT (nomeri, asaki, anamnezi, sawyisi Sedegebis gareSe) gagzavnil iqna holandiel eqspertebTan da ZuZus kibos skriningis saswavlo centrSi (niderlandebi), sadac moxda mamogramebis ormagi wakiTxva; SemdgomSi moxdeba konsensusis safuZvelze miRebuli am Sedegebis Sedareba saqarTveloSi miRebul SedegebTan. kvlevis sawyisi faza dasruldeba 2012 wlis ianvris bolos da miRebuli Sedegebi ganxiluli iqneba qarTveli kolegebis mier.

kvlevis mosalodneli Sedegebia:

kvleva uzrunvelyofs saqarTveloSi Catarebuli mamografiuli gamokvlevebis sizustis damoukidebel Sefasebas. miRebuli monacemebi mogvcemen im sferoebis gamovlenis SesaZleblobas, romlebic saWiroeben gaumjobesebas. Semdgomi progresis Sefasebisas miRebuli Sedegebi gamoyenebuli iqneba rogorc aTvlis wertili;

cxadia, rom negatiuri mamogramebis raodenoba ar aris sakmarisi imisaTvis, rom movaxdinoT saqarTveloSi cru-uaryofiTi mamografiis sixSiris statistikurad sando gaangariSeba. aqedan gamomdinare,


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zemoTaRniSnuli kvleva gansazRvravs, arsebobs Tu ara ufro farTomasStabiani kvlevis Catarebis aucilebloba am parametris dasadgenad;

am kvlevis Sedegebidan gamomdinare, miRebuli monacemebi SeiZleba gaerTiandes erT statiaSi da kvlevis yvela monawilis Tanxmobis SemTxvevaSi moxdes misi gamoqveyneba.

6. 2011 wels skriningis erovnuli centris iniciativiT proeqtSi damatebiT CaerTo kidev erTi evropuli teqnikuri dawesebuleba – onkologiis evropuli skola (ESO). saqarTveloSi Sesabamisi simZlavreebis Seqmnaze orientirebuli RonisZiebebis damatebiTi mxardaWeris uzrunvelyofis mizniT aRniSnulma organizaciam UNFPA-s saqarTvelos ofisTan koordinirebiT SeimuSava saqarTveloSi muSaobis 3-5 wliani gegma.

onkologiis evropuli skolis eqspertebma 2011 wlis 13-14 dekembers Tbilisis saxelmwifo samedicino universitetis SenobaSi radiologebisa da rentgenologebisaTvis Caatares ZuZus kibos skriningis ordRiani Teoriuli da praqtikuli saswavlo kursi. aRniSnuli saswavlo kursi, romelSic monawileoba miiRo 35 specialistma Tbilisidan da regionebidan, Catarda onkologiis evropuli skolisa da UNFPA-s saqarTvelos ofisis erToblivi mxardaWeriT. saswavlo kursi warmarTes onkologiis evropuli skolis eqspertebma doqtorma roselim da doqtorma ambrojetim. Teoriuli mecadineobebis Semdeg, romlebic eZRvneboda skriningSi monawile radiologebisTvis saintereso sxvadasxva Temebs, didi dro daeTmo specifikuri klinikuri SemTxvevebis ganxilvas, rac miznad isaxavda rogorc ZuZus keTilTvisebiani da avTvisebiani dazianebebis diferencirebis, aseve ganmeorebiTi gamokvlevebis daniSvnis ZiriTadi kriteriumebis gacnobas. skriningis erovnuli centris m. kaCinskis sax filialSi 20 radiografers samuSao adgilze Cautarda treningi. onkologiis evropuli skolis eqspertebis azriT radiologebi da radograferebi saWiroeben damatebiT momzadebas sterotaqsikuri biofsiis sakiTxebSi. garda amisa, xazi gausves mamografiuli skriningis programaSi samedicino fizikis specialistis sistematuri monawileobis aucileblobas, romelmac unda uzrunvelyos radiaciuli usafrTxoebis dacva saerTaSoriso standartebis Sesabamisad.

skriningis erovnuli centri da onkologiis evropuli skola SeTanxmdnen TanamSromlobis gagrZelebaze am ukanasknelsa da sriningis programas Soris, romelic unda ganxorcieldes Sjsds-s, UNFPA-s ofisis da


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saqarTveloSi italiis saelCos mxardaWeriT da miznad isaxavs ZuZus kibos skriningis programis xarisxis gaumjobesebas.

aRniSnuli miznis gansaxorcieleblad mxareebi SeTanxmdnen Semdegze:

TbilisSi skriningis erovnul centrTan Seiqmnas multidisciplinaruli erovnuli referaluri centri, romelic dakompleqtdeba Semdegi specialistebiT – epidemiologi, radiologi, rentgenologi, samedicino fizikis specialisti an inJineri da paTologi;

onkologiis evropuli skolis rekomendaciiT SemuSavdes saswavlo programa erovnuli referaluri centris specialistebisaTvis, romlebic SeZleben SeZenili unar-Cvevebis swavlebas ZuZus kibos skriningis saqarTvelos erovnuli programis monawile sxva dawesebulebebSi;

onkologiis evropuli skolis winaswari gegmebi 2012 wlisaTvis moicavs:

- samedicino fizikis specialistis an inJinris 2-4 kvirian momzadebas

evropaSi (savaraudod niderlandebis qalaq niimegenSi);

- paTologiis specialistis 2-4 kvirian momzadebas evropis erT-erT

dawesebulebaSi;

- stereotaqsikuri gamokvlevebis dawyebisa da ultrabgeriTi biofsiis

meTodebis gamoyenebis mizniT mowveuli profesoris mier TbilisSi

radiologebisaTvis erTkviriani saswavlo kursis Catarebas;

- mowveuli profesoris mier TbilisSi erTkviriani kursis Catarebas

erovnuli programis epidemiologiuri SefasebisaTvis saWiro monacemTa

Sekrebis modelebis ganxilvis mizniT;

- 2012 wlis seqtember-oqtomberSi paTologiebis sakiTxebisadmi miZRvnili

seminarisa da radiologebis meore nacionaluri seminaris organizebas.

7. proeqti mxars uWers skriningis programaSi pirveladi jandacvis (pjd) specialistebis farTo monawileobas. im mizniT 2011 wlis dekemberSi gorSi Catarda tradiciuli seminarebi pjd specialistebisaTvis. semminaris amocanebs Seadgenda:

eqimebisaTvis detaluri informaciis miwodeba ZuZusa da saSvilosnos yelis kibos skriningis programaSi pjd rgolis monawileobis mniSvnelobis Sesaxeb;

pirveladi jandacvis sistemis eqimebis CarTva ZuZusa da saSvilosnos yelis kibos programebis Sesaxeb mosaxleobis ganaTlebis procesebSi.

seminarebis dros msmenelebi gaecnen ZuZusa da saSvilosnos yelis kibos skriningis programis rogorc sabaziso klinikur, ise marTvis aspeqtebs. seminaris monawileebs daurigdaT pjd specialistebisaTvis UNFPA-s mxardaWeriT SemuSavebuli ZuZusa da saSvilosnos yelis kibos skriningis specialuri saxelmZRvanelo “ZuZusa da saSvilosnos yelis kibos prevenciisa da skriningis ZiriTadi aspeqtebi. gaidlainebi pjd eqimebisaTvis”. sul seminarSi monawileobda pirveladi jandacvis 50 specialisti.

8. UNFPA kvlavac xels uwyobda skriningis programis ganmaxorcielebeli partniorebis SesaZleblobebis gaZlierebas programis marTvis aspeqtebSi. am


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mimarTebiT UNFPA-s mxardaWeriT Tbilisisa da regionebis warmomadgeneli menejerebisa da wamyvani specialistebisaTvis Catarda ori seminari Temaze “skriningis programis marTvis xarisxis uzrunvelyofa” (05.06.2011 da 17.11.2011).

9. Cvens qveyanaSi kiboTi gamowveuli avadobisa da sikvdilianobis monitoringisaTvis saWiro Tanamedrove da kargad organizebuli registris SemuSavebis aucileblobis gaTvaliswinebiT UNFPA-m da saSvilosnos yelis kibos evropis asociaciam 2011 wlis 7-9 dekembers daavadebaTa kontrolis erovnuli centris ori wamyvani specialisti saswavlo vizitiT gagzavnes niderlandebis onkologiur centrSi. qarTvel specialistebs SesaZlebloba hqondaT gacnobodnen kibos registrSi monacemTa Sekrebis sistemas; registrSi monacemTa xarisxis monitoringis, Sefasebisa da klasifikaciis meTodebs, ris safuZvelzec SemuSavda rigi rekomendaciebisa, romlebic gaTvaliswinebuli iqneba saqarTveloSi kibos registris modelis Seqmnisas. aRniSnuli rekomendaciebi wardgenili da ganxiluli iyo daavadebaTa kontrolis erovnuli centris mier 2011 wlis 16 dekembers organizebul strategiul sxdomaze, romelSic monawileobda yvela adgilobrivi da saerTaSoriso partniori.

mosaxლeobis qcevis Secvlaze orientirebuli sainformacio kampania

UNFPA-s mxardaWeriT moxda erovnuli skrining-centris re-brendingi: Seiqmna axali logo; momzadda axali sainformacio-saganmanaTleblo bukletebi; axali “stilis” Sesabamisad Seicvala centris veb-gverdis dizaini da struqtura (www.gnsc.ge) da igi gaxda momxmareblisaTvis ufro komfortuli. ganaxlebuli centri da skriningis programa mTlianobaSi ufro TvalsaCino da advilad cnobadi gaxda mosaxleobisaTvis. es cvlilebebi ueWvelad ganapirobeben servisebiT sargeblobis zrdas.

am TvalsazrisiT saangariSi periodSi ganxorcielda Semdegi

RonisZiebebi:

sazogadoebrivi televiziis arxiT regularulad da ufasod xdeboda prostatis kibos skriningis Sesaxeb axali komerciuli rgolis translireba;

UNFPA-s mxardaWeriT sami Tvis ganmavlobaSi (2011 wlis seqtember-dekemberi) warmoebda prostatis kibos skriningis

http://www.gnsc.ge/


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Sesaxeb კომერციული რგოლის ტრანსლირება ყველაზე პოპულარულ კომერციულ

ტელეარხებზე, რომლებიც მოიცავენ საქართველოს მთელს ტერიტორიას;

sazogadoebriv avtobusebze, metropolitenis sadgurebSi da matareblebis

vagonebSi 2011 wlis 1 სექტემბრიდან 3 Tvis vadiT ganTavsda specialuri banerebi informaciiT skriningis programis Sesaxeb;

popularul sazogadoebriv da samedicino veb-gverdebze ganTavsda sareklamo banerebi informaciiT skriningis programis Sesaxeb;

daibeWda da zogadad Tbilisis mosaxleobasa da qalTa mosaxleobis im nawilSi, romlebmac gaiares skriningi, gavrcelda 20 aTasi broSura kibos adreul etapze gamovlenis da ZuZusa da saSvilosnos yelis kibos

skriningis პროგრამის mniSvnelobis Sesaxeb. garda amisa daibeWda da gavrcelda 20 aTasi broSura ZuZus TviTgasinjvis Sesaxeb da 20 aTasi specialuri sareklamo bukleti.

saangariSo periodSi ZuZus, saSvilosnos yelis, პროსტატისა და მსხვილი

ნაწლავის kibos skriningisa da adreuli diagnostikis servisebiT uzrunvelyofa

skriningis programis mizania ZuZus, saSvilosnos yelis, protatis da msxvili nawlavis kibos adreuli gamovlenis maCveneblebis maqsimalurad gazrda samizne mosaxleobaSi da kiboTi gamowveuli avadobisa da sikvdilianobis Semcireba.

2011 wlis ianvari-dekembris periodSi:

ZuZus kibos skriningi Cautarda Tbilisis da Tbilisis Semogarenis macxovrebel, 40–70 asakobrivi jgufis 13,912 qals;

saSvilosnos yelis kibos skriningi ki Tbilisis da Tbilisis Segarenis macxovrebel, 25–60 asakobrivi jgufis 14,372 qals;

prostatis kibos skriningi Cautarda 45-70 wlis asakobrivi jgufis 3,784 mamakacs;

msxvili nawlavis kibos skriningi Cautarda 50-70 asakobrivi jgufis rogorc mamrobiTi, aseve mdedrobiTi sqesis 1,368 pacients (ix. cxrili 1).

yvela SemTxvevaTa skriningis 85%-ze meti ganaxorciela skriningis erovnulma centrma, xolo darCenili nawilisa ki qve-kontraqtorma partniorebma maTdami daqvemdebarebul samkurnalo da diagnostikur centrebSi.


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cxrili 1. ZuZus, saSvilosnos yelis, prostatis da msxvili nawlavis skriningis SemTxvevebis raodenoba

skriningis programis komponenti raodenoba procenti

ZuZis kibo (mamografia) 13,912 100%

skriningis erovnuli centri 11,487 82.6%

tatiSvilis samedicino centri 1,295 9.3%

Tbilisis onkologiis centri 1,025 7.4%

RuduSauris sax. samedicino centri 51 0.4%

Tbilisis balneologiuri kurorti 54 0.4%

saSvilosnos yelis kibo (PAP Test) 14,372 100%


tatiSvilis samedicino centri 1,197 8.3%

Tbilisis onkologiis centri 1,239 8.6%


prostatis kibo (PSA) 3,784 100%


tatiSvilis samedicino centri 400 10.6%

Tbilisis onkologiis centri 125 3.3% eqspres-diagnostika 82 2.2%


msxvili nawlavis kibo (FOBT) 1,368 100%


tatiSvilis samedicino centri 64 4.7%

Tbilisis onkologiis centri 37 2.7%


saangariSo periodSi damatebiTi gamokvlevebisaTvis Catarebuli diagnostikuri procedurebis procentuli maCveneblebi ganawilda Semdegi saxiT: im qalTa saerTo raodenobidan, romelmac gaiares ZuZus kibos skriningi, ultrabgeriTi gamokvleva Cautarda 28%-s, xolo citologiuri gamokvleva ki 3.9%-s (cxrili 2); im qalTa saerTo raodenobidan, visac Cautarda saSvilosnos yelis kibos skriningi, kolposkopiuri gamokvleva Cautarda 15%-s, xolo biofsia 1.75%-s (cxrili 3). kolonoskopia Cautarda msxvili nawlavis kiboze gamokvleul pacientTa 4%-s. cxrili 2. ZuZus kibos skriningi: Catarebuli gamokvlevebis saerTo raodenoba da procentuli wili, 2011

mamografia ultrabgera citologia

skriningis erovnuli centri 11,487 3,671 (32%) 453 (3.9%)

tatiSvilis samedicino centri 1,295 153 (12%) 11 (1.1%)

Tbilisis onkologiis centri 1,025 116 (11%) 2 (0.2%) RuduSauris sax. samedicino

centri 51 0 0

Tbilisis balneologiuri kurorti 54

6 (11%) 0

sul 13,912 3,946 (28%) 466 (3.3%)


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cxrili 3. saSvilosnos yelis kibos skriningi: Catarebuli gamokvlevebis saerTo raodenoba da procentuli wili, 2011

PAP nacxi kolposkopia biofsia

skriningis erovnuli centri 11,877 2,024 (17%) 252 (2.1%) tatiSvilis samedicino

centri 1,197 50 (4%) 0

Tbilisis onkologiis centri 1,239 86 (7%) 0 Tbilisis balneologiuri kurorti 59

0 0

sul 14,372 2,160 (15%) 252 (1.75%)

cxrili 4. msxvili nawlavis kibos skriningi: Catarebuli gamokvlevebis saerTo raodenoba da procentuli wili, 2011

FOBT testi kolonoskopia

skriningis erovnuli centri 1,219 49 (4%) tatiSvilis samedicino

centri 64 0

Tbilisis onkologiis centri 37 5 (13.5%) Tbilisis balneologiuri kurorti 8

0

sul 1,368 54 (4%)

ZuZus kibos skriningis meore raundi daiwyo 2010 wels. 2011 wels ZuZus kiboze gamokvleul qalTa saerTo raodenobidan (13,912) 2,153 pacienti gamocxadda ganmeorebiT skriningze, rac Seadgens 2009 wels erovnul skrining centrSi gamokvleuli kontingentis 25%-s da im pacientTa 51%-s, visac skriningis erovnuli centri ganmeorebiT skriningze mowvevis mizniT daukavSirda telefoniT.

2011 wlis maisSi daiwyo saSvilosnos yelis kibos skriningis meore etapi. am periodSi ganmeorebiT gamokvleuli iqna 718 qali, rac Seadgens 2008 wlis maisi-dekembris periodSi erovnul skrining centrSi gamokvleuli kontingentis 17%-s da im pacientTa 34%-s, visac skriningis erovnuli centri ganmeorebiT skriningze mowvevis mizniT daukavSirda telefoniT.

476 qalidan, romlebsac CautardaT ZuZus citologiuri kvleva, 88 SemTxvevaSi (19%) gamovlinda ZuZus avTvisebiani simsivne, 28 SemTxveva (6%) saeWvo iyo avTvisebiani simsivnis arsebobaze, 47 SemTxvevaSi (19%) adgili hqonda atipiur/aradiferencirebul simsivneebs, 253 SemTxvevaSi (54%) gamovlinda keTilTvisebiani simsivne da 50 (10%) SemTxvevaSi aRebuli sinji miCneuli iqna Seusabamod testis Casatareblad (cxrili 5).


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cxrili 5. ZuZus kibos skriningis citologiuri Sedegebi, 2011

citologiuri Sedegi N %

araadeqvaturi 50 10.7% keTilTvisebiani 253 54.3% atipiuri/aradiferencirebuli 47 10.1% saeWvo avTvisebian simsivneze 28 6.0% avTvisebiani 88 18.9% sul 466 100,00%

erovnul skrining centrSi gamokvleuli 630 qali specialistTa jgufis mier, romlis SemadgenlobaSi Sediodnen radiologi, paT/citologi da qirurgi, Semdgomi gamokvlevebisa da mkurnalobisTvis gagzavnil iqna specializebul samedicino dawesebulebebSin (cxrili 6).

cxrili 6. sriningis erovnuli programidan pacientTa gagzavna ZuZus kibos specializirebuli mkurnalobisaTvis, 2011

samedicino dawesebuleba gagzavnili pacientebis raodenoba

saerTo daodenobis % (N=13,912)

skriningis erovnuli centri 463 4% tatiSvilis samedicino

centri 31 2.4%

Tbilisis onkologiis centri 136 13.3% sul 630 4.5%

amJamad mimdinareobs yoveli pacientis gamokvlevisSemdgomi mkurnalobis Sedegebis Sesaxeb informaciis Sekreba da informacia xelmisawvdomi gaxdeba 2012 wlis martis bolos. 2011 wlis pirveli 6 Tvis winaswari Sedegebis mixedviT skriningis programis farglebSi ZuZus kibos SemTxvevebis 78% gamovlenili iqna daavadebis I-II stadiebze (sqema 1).

sqema 1. ZuZus kibos stadiebi (winaswari, ianvari-ivnisi, 2011)

2011 wels Catarebuli 14,372 pap testidan 90.5% normis farglebSi iyo, xolo danarCeni 1,369 (9.5%) testi kvalificirebuli iyo, rogorc anomaluri. es Sedegebi gadanawilda Semdegnairad: 808 (59%) – daudgeneli mniSvnelobis atipiuri ujredebi (ASCUS), 116 (8.47%) qals daudginda atipiuri skvamozuri ujredebis


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arseboba – ver gamovricxavT HSIL (ASC-H), 272 (19.9%) SemTxvevaSi adgili hqonda dabali xarisxis skvamozur intraepiTelialur dazianebebs (LSIL), 159 (11.6%)

SemTxvevaSi – maRali xarisxis skvamozur intraepiTelialur dazianebebs (HSIL), 7

(0.51%) SemTxvevaSi gamovlinda dauzustebeli mniSvnelobis atipiuri jirkvlovani ujredebi, anu atipiuri jirkvlovani ujredebi (AGUS/AGC) da 7 (0,51%) SemTxvevaSi Sedegebi klasificirebuli iyo rogorc invaziuri karcinoma (cxrili 7). PAP

testis anomaluri Sedegebis mqone yvela qals eZleoda rekomendacia PAP testis ganmeorebiT CaetarebinaT 6–12 TveSi.

cxrili 7. pap testis citologiuri Sedegebi, 2011

atipiuri PAP testi N

Pap testis anomaluri Sedegebis

ganawileba (%)

(N=1,369)

Pap testis anomaluri Sedegebi (%) gamokvleulTa

saerTo raodenobidan

(N=14,372)

ASCUS 808 59.02% 5.62%

ASC-H 116 8.47% 0.81%

LSIL 272 19.87% 1.89%

HSIL 159 11.61% 1.11%

AGUS/AGC 7 0.51% 0.05%

karcinoma 7 0.51% 0.05%

sul 1369 100.00% 9.53%

skriningis erovnuli centri kolposkopiur gamokvlevas atarebs ori Cvenebis safuZvelze: pap testis anomaluri Sedegi da ginekologis rekomendacia. 2011 wels kolposkopiuri gamokvleva Cautarda pap testis anomaluri Sedegebis mqone 1,197 qals, maT Soris 33.2%-s histologiuri maCveneblebi normis farglebSi iyo, 20.6%-Si adgili hqonda aradamakmayofilebel kolposkopias, 35.5%-Si gamovlinda CIN1, 8.9%-Si - CIN2,3, xolo 1.5%-Si – gamovlinda invaziuri kibo (kolposkopiuri gamokvlevebis Sedegebis detaluri analizi pap testis atipiuri Sedegebis mixedviT warmodgenilia cxrilSi 8.1.

cxrili 8.1 atipiuri pap testis mqone qalebis kolposkopiuri gamokvlevis Sedegebi, 2011

citologiuri/ kolposkopiuri diagnozi

norma

aradamakmayofilebeli

kolposkopia

CIN1

CIN2,3

invaziuri kibo

raodenoba

(%)

raodenoba (%)

raodenoba

(%)

raodenoba

(%)

raodenoba

(%)

ASCUS (n =725) 310 42.8% 146 20.1% 254 35.0% 15 2.1% 0 0.0%

ASC-H (n = 97) 16 16.5% 38 39.2% 29 29.9% 9 9.3% 5 5.2%

LSIL (n = 239) 69 28.9% 37 15.5% 128 53.6% 5 2.1% 0 0.0%

AGUS/AGS (n=5) 1 20.0% 3 60.0% 1 20.0% 0 0.0% 0 0.0%

HSIL (n = 130) 2 1.5% 22 16.9% 17 13.1% 77 59.2% 12 9.2%


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karcinoma (n=1) 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 100.0%

sul ( n = 1197) 398 33.2% 246 20.6% 429 35.8% 106 8.9% 18 1.5%

normaluri pap testis mqone qalebis kolposkopiurma kvlevam gamoavlina, rom 34%-Si kolposkopiuri kvlevis monacemebi aseve normis farglebSi iyo, 18%-Si – gvxvdeboda polipi, 12.4%-s – aradamakmayofilebeli kolposkopia, 33.8%-Si gamovlinda CIN1, 1.3%-Si - CIN2,3, xolo 0.1%-Si gamovlinda invaziuri kibo (cxrili 8.2).

cxrili 8.2 normaluri pap testis mqone qalebis kolposkopiuri gamokvlevis Sedegebi, 2011

citologiuri/ kolposkopiuri diagnozi

norma

polip.

aradamakmayofilebeli

kolposkopia

CIN1

CIN2,3

invaziuri kibo

raodenoba

(%)

raodenoba

(%)

raodenoba

(%)

raodenoba

(%)

raodenoba (%)

raodenoba

(%) normaluri pap testi

(n=992)

338 34.1% 182 18.3% 123 12.4% 335 33.8% 13 1.3% 1 0.1%

im pacientebs, romlebsac daudgindaT CIN 2,3 an arsebobda eWvi invaziur kiboze, miecaT rekomendacia saTanado mkurnalobis misaRebad miemarTaT specializirebuli samedicino dawesebulebisaTvis. 2011 wels saSvilosnos yelis kibos arsebobaze eWvis safuZvelze aseTi rekomendacia mieca 41 qals. skriningis erovnul centrSi ganxorcielda 96 amokveTis da 5 ablaciis operacia.

histopaTologiuri biofsiis Sedegebma gamoavlina CIN1-s 33 SemTxveva, CIN2-s 34 SemTxveva, CIN3-is 22 SemTxveva, CIN3-CIS-is 6 SemTxveva, invaziuri kibos 1 da vaginaluri neoplaziis 2 SemTxveva - VAIN1.

prostatis kiboze gamokvleuli 3,784 mamakacidan 292-is (7.7%) testi pozitiuri iyo da yvela maTgans gaewia rekomendacia, miemarTaT specializirebuli klinikisaTvis.

msxvili nawlavis kiboze gamokvleuli 1,368 pacientidan 54-is (4%) testi pozitiuri iyo da yvela maTgans Cautarda kolonoskopia da gagzavnili iqnen specializirebul klinikaSi.

ambulatoriuli qirurgiuli mkurnaloba

saangariSo periodSi skriningis erovnul centrSi kiboswina mdgomareobebis qirurgiuli operacia da manipulaciebi Cautarda 168 pacients (cxrili 9).


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cxrili 9. ambulatoriuli daxmareba (qirurgia), 2011

manipulaciebi adgilobrivi anesTeziiT kistas aspiracia

23

adgilobrivi anesTeziiT Catarebuli seqtoruli rezeqcia

107

adgilobrivi anesTeziiT Catarebuli ormxrivi seqtoruli rezeqcia

21

adgilobrivi anesTeziiT Catarebuli kanis avTvisebiani dazianebis rezeqcia

38

mokveTa/ablacia 1

LEEP 73

sul 263

programis mimdinareobis periodSi Segrovili detaluri informacia ZuZus da saSvilosnos yelis kibos skriningis epidemiologiuri monacemebis Sesaxeb ixileT danarTSi 1.

kvlevis, monitoringisa da Sefasebis Sedegad miRebuli informacia

Tbilisis municipalitetisa da UNFPA–s mier indikatorebis gansazRvra moxda skriningis programis dawyebisTanave. kibos skriningis yvela komponentisaTvis indikators warmoadgens erTi wlis ganmavlobaSi kibis skriningis TiToeuli mimarTulebiT gamokvleuli samizne mosaxleobis procentuli wili. gamosakvlevi mosaxleobis raodenoba damokidebulia yovelwliurad proeqtisaTvis gamoyofil biujetze. erovnuli statistikuri monacemebis Tanaxmad TbilisSi cxovrobs 40-70 wlis asakobrivi jgufis 253,147 qali, romlebic warmoadgenen ZuZus kibos skriningis samizne mosaxleobis. radganac ZuZus kibos skriningi tardeba 2 weliwadSi erTxel, wliuri samizne mosaxleoba iqneba 126,575 (253,147/2). arsebuli biujetidan gamomdinare, mxolod am raodenobis 20% mocva iyo SesaZlebeli wliurad. ase, rom, ZuZus kibos skriningis 2011 wlis samizne mosaxleoba iyo (253,147/2)x20%=25,315. aRniSnul informaciaze dayrdnobiT cxrilSi #10 mocemulia 2011 wels TbilisSi skriningis programis Sesruleba indikatorebis mixedviT. naTelia, rom skriningis erovnulma programam meti Zalisxmeva unda moaxmaros skriningis programaSi samizne mosaxleobis monawileobis maCvenebelTa gazrdas.

cxrili 10. skriningis erovnuli programis Sesruleba TbilisSi, 2011

kibos skriningis komponenti

samizne mosaxleoba

gamokvleulTa raodenoba

procentuli maCvenebeli (indikatori)

ZuZus kibo 25,315 13,912 55%

saSvilosnos yelis kibo

22,266 14,372 65%

prostatis kibo 29,212 3,776 13%

msxvili nawlavis kibo

53,861 1,198 2%


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erovnuli skrining centri monitoringisa da Sefasebis da programis Sesrulebis xarisxis Sida kontrolis RonisZiebebis farglebSi sistematurad atarebs pacientebis kmayofilebis kvlevas. 2011 wels Catarda pacientebis kmayofilebis kvleva, romlis drosac gamoyenebuli iqna randomizirebuli principiT SerCeuli

individi, daaxloebiT 100 beneficiari proeqtSi monawile ToToeuli samedicino dawesebulebidan. gamokiTxva sruliad anonimuria da masSi ar fiqsirdeba aranairi piradi informacia. kiTxvari Seicavs punqtebs, romlebic gansazRvraven pacientis kmayofilebas an ukmayofilebas miwodebuli servisebiT. amasTan, masSi mocemulia kiTxvebi, romlebic saSualebas gvaZleven ganvsazRvroT informaciis wyaro, saidanac pacientma Seityo skriningis programis Sesaxeb. pasuxebis Sefaseba xdeba 1-dan 5- qulamde, sadac 1 aRniSnavs srul Tanxmobas, 3 – neitralur Sefasebas, xolo 5 srul uaryofas. Sekrebili monacemebis analizi xdeba specialurad

SemuSavebuli programiT Epi Info (versia 3.5.1) (danarTi 2 – kiTxvari da pacientTa kmayofilebis Seswavlis Sedegebi). zogadad, qalebis 90% kmayofilia miRebuli servisebiT da personalis damokidebulebiT. isini siamovnebiT gauweven rekomendacias Tavis megobrebs da axloblebs, rom mimarTon skriningis programas. mniSvnelovania isic, rom wina wlis SedegebTan SedarebiT 2011 wels pacientTa mier skrininguli momsaxurebis miRebis mocdis dro mniSvnelovnad Semcirda. ufro metic, aravis ganucxadebia, rom Seeqmna sirTuleebi skriningze vizitis daniSvnasTan dakavSirebiT. aseve adgili ar hqonia pacientis sxva dawesebulebaSi an eqimTan gagzavnis SemTxvevas. pacientTa naxevarma (50%) ganacxada, rom programis Sesaxeb Seityves televiziis meSveobiT, 33%-ma – megobrebisgan da naTesavebisgan, xolo 17%-ma ki informaciis iseTi sxva wyaroebidan, rogoricaa presa, radio da sazogadoebriv transportze ganTavsebuli reklamebi. gamokvleuli mosaxleobis 98%-ma ganacxada, rom mzadaa miRebuli rekomendaciis mixedviT kidev erTxel mimarTos programas. garda amisa, isini urCeven megobrebs da naTesavebs, isargeblon skriningis programis servisebiT.

ZiriTadi xelSemSleli da xelSemwyobi faqtorebi

ZiriTadi xelSemSleli da xelSemwyobi faqtorebi warmoadgenda mTavar gansaxilvel sakiTxs 2011 wlis 22 ivniss da 25 noembers Catarebul proeqtis mmarTveli gundis Sexvedrebze, romelsac eswrebodnen saqarTvelos pirveli ledi, Tbilisis municipalitetis, skriningis erovnuli centrisa da UNFPA–s warmomadgenlebi. am Sexvedrebze miRweuli iqna SeTanxmeba TbilisSi proeqtis gafarToebis Sesaxeb axali qve-kontraqtori organizaciebis gansazRvrisa da programaSi CarTvis meSveobiT, rac gazrdis momsaxurebisadmi geografiul xelmisawvdomobas Tbilisis mosaxleobisaTvis, es ki Tavis mxriv xels Seuwyobs municipalitetis mier proeqtisaTvis gamoyofili Tanxebis efeqturad gamoyenebas, moxdeba skriningis erovnul centrSi da Tbilisis onkodispanserSi kiboswina daavadebebis ambulatoriuli mkurnalobis (saSvilosnos yelis kibos skriningis komponentis farglebSi) xarjebis anazRaureba. es Tavis mxriv gazrdis servisebisadmi xelmisawvdomobas. garda amisa, miRweuli iqna SeTanxmeba pjd doneze saSvilosnos yelis kibos skriningis danergvis Sesaxeb.

beneficiarebis satelefono gamokiTxvis meTodi. sul gamokiTxuli iqna 400


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ZiriTadi xelSemSleli faqtorebi: 2011 wlis ianvari-oqtombris periodis statistikuri da epidemiologiuri monacemebis analizis safuZvelze gamovlinda Semdegi problemebi:

- skriningis programaSi monawileobis saerTo maCvenebeli meryeobs dabalidan saSualomde da araTanabradaa ganawilebuli skriningis programaSi monawile samedicino dawesebulebebs Soris;

- ZuZus da saSvilosnos yelis kibos ganmeorebiT skriningze pacientebis mozidvis arasaTanado maCvenebeli, rac SeiZleba ganpirobebuli iyos pacientebis sakontaqto telefonis araswori nomrebiT, pacientis mowvevis protokolis ararsebobiT, am konkretuli amocanis SesrulebisaTvis gamoyofili sakadro resursebis naklebobiT an dabali kvalifikaciiT da sxva gare faqtorebiT. magaliTad, 2011 wels skriningis programa realurad telefoniT daukavSirda 2009 wels ZuZus kiboze gamokvleuli pacientebis mxolod naxevars, romelTagan ganmeorebiTi skriningi Caitara mxolod 50%-ma. msgavsi problema arsebobs saSvilosnos yelis kibos ganmeorebiT skriningTan dakavSirebiTac.

programis ganxorcielebis ZiriTadi xelSemwyobi faqtorebi, romlebmac ganapirobes programis warmatebuli funqcionireba:

- SemuSavda da skriningis erovnul centrSi amJamad testirebas gadis skriningis kompiuteruli programa. programa SemuSavebulia im mizniT, rom erTis mxriv srulad daakmayofilos administraciuli da klinikuri informaciis marTvis saWiroebebi da meores mxriv SeZlos finansuri informaciis marTvis saWiroebebis nawilobriv dakmayofileba. finansuri marTvis saWiroebebis srulad dakmayofilebis mizniT 2012 wels skriningis centris eqimebisa da xelmZRvanelobis moTxovnebis Sesabamisad moxdeba programis ganaxleba. am mimarTebiT skriningis centris sainformacio teqnlogiebis specialistis mier muSavdeba 2012 Casatarebeli samuSaoebis gegma.

- saqarTvelos mTavrobis mzadyofna, moaxdinos ZuZus, saSvilosnos yelis, prostatis da msxvili nawlavis kibos skriningis danergva qveynis yvela regionSi;

- partnioruli urTierTobebi gaerosa da saqarTvelos mTavrobas Soris: es erTaderTi proeqtia, romelSic saqarTvelos mTavroba UNFPA-sTan TanamSromlobiT axorcielebs fondebis investirebas kibos skriningisaTvis;

- erovnuli simZlavreebis ganviTarebis mizniT partnioruli urTierTobebis Camoyalibeba evrokavSiris qveynebis wamyvan samedicino dawesebulebebsa da saqarTvelos samedicino dawesebulebebs Soris;

- qselis Seqmna: proeqtis meSveobiT Seiqmna da gaZlierda qseli, romelSic gaerTiandnen ara mxolod adgilobrivi da saerTaSoriso specialistebi (gansakuTrebiT es exeba Savi zRvis regions), aramed saqarTvelos dedaqalaqSi da regionebSi momuSave profesionalebic;

- Sedegebze dafuZnebuli marTva da angariSgeba: proeqti warmoadgens

angariSgebis, efeqtianobisa da gamWvirvalobis karg magaliTs;

- UNFPA–s wvlili: finansuri, teqnikuri da samenejmento mxardaWera; proeqtis menejmenti xorcieldeboda UNFPA–s politikisa da procedurebis gaTvaliswinebiT, rac dadebiTad aisaxa proeqtis Sesrulebis efeqtianobaze.


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proeqtisaTvis sargeblobis momtani iyo is kavSirebi, romlebic damyarda UNFPA–s programis egidiT mimdinare sxva proeqtebTan.

partnioruli urTierTobebi

proeqti axorcielebs metad nayofier TanamSromlobas saqarTvelos reproduqciuli janmrTelobis erovnul sabWosTan, romlis Tavmjdomarea saqarTvelos pirveli ledi. sabWo uzrunvelyofs aRniSnuli sferoTi dainteresebuli donorebis saqmianobis koordinirebas.

proeqtis farglebSi kidev ufro ganmtkicda partnioruli urTierTobebi saSvilosnos yelis kibos evropis asociaciasTan da kibos saerTaSoriso kontrolis kavSirTan.

- 2011 wlis maisSi kibos saerTaSoriso kontrolis kavSirisa da UNFPA-s mxardaWeriT skriningis erovnuli centris orma citopaTologma italiaSi gaiara saswavlo kursi;

- saqarTveloSi, adgilobrivi citopaTologebisaTvis italieli citologebis – prof. cezare jentilisa da doqtori di bontis – mier Catarda saswavlo seminari;

2011 wels damyarda ramdenime axali partnioruli kavSiri:

- onkologiis evropul skolasTan – aRniSnuli skolis saerTaSoriso eqspertebis mier saqarTveloSi radiologebisa da rentgenologebisaTvis Catarda ordRiani saswavlo seminari da SemuSavebis fazaSia momavali 4-5 wlis samuSao gegma;

- holandiel eqspertebTan da ZuZus kibos skriningis saswavlo centrTan – am partnioruli urTierTobis mizania saqarTveloSi Catarebuli mamografiuli skriningisa da diagnostikis sizustis Sefaseba da misi Sedareba dasavleT evropaSi moqmed standartebTan. amasTan, partniorobis farglebSi SemuSavdeba ZuZus kibos skriningis programis xarisxis uzrunvelyofis meqanizmebi;

- kolposkopiisa da saSvilosnos yelis paTologiebis evropul federaciasTan – am partniorobis farglebSi orma ginekologma-kolposkopistma did britaneTSi gaiara saswavlo kursi. swavlebis mizani iyo kolposkopiis sakiTxebSi Teoriuli codnis amaRleba da praqtikuli unar-Cvevebis srulyofa;

- holandiis onkologiur centrTan –aRniSnuli TanamSromloba moicavs daavadebaTa kontrolis erovnuli centris specialistebisaTvis teqnikuri

gamocdilebis gaziarebas kibos erovnuli registris SeqmnasTan dakavSirebiT..


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UNFPA-s da skriningis erovnuli centris TanamSromlebma monawileoba miiRes UNFPA-s teqnikuri ganyofilebis mier 2011 wlis maisSi antaliaSi, TurqeTSi organizebul globalur SexvedraSi, romelic eZRvneboda saSvilosnos yelis kibos prevencias.

simZlavreebis Seqmnaze orientirebuli sxvadasxva RonisZiebebis meSveobiT kidev ufro gaZlierda da gaRrmavda erovnuli skrining centris partnioruli urTierTobebi da TanamSromloba mis qvekontraqtorebTan da kibos skriningis programaSi monawile sxva regionalur samedicino dawesebulebebTan.

V. finansuri ganxorcieleba

proeqtis finansuri ganxorcieleba swarmoebda proeqtis damtkicebuli biujetis mixedviT. Finansebis aTvisebis maCvenebeli Seadgens 100%; finansuri ganxorcielebis detalebi ixileT danarTSi 3.

VI. samomavlo gegma

i. skriningis programebis menejmentisa da xarisxiani momsaxurebis miwodebis mizniT erovnuli simZlavreebis ganviTarebis xelSewyoba;

ii. Tbilisis skriningis programis dizainisa da menejmentis Semdgomi gaumjobesebis xelSewyoba, rac moicavs saSvilosnos yelis kibos skriningis procesebSi pirveladi jandacvis sistemis CarTvas;

iii. Savi zRvis qveynebis koaliciis ZuZus da saSvilosnos yelis kibos prevenciis programisa da mis farglebSi SemuSavebuli sxva iseTi iniciativebis mxardaWera, rogoricaa partnioruli urTierTobebis damyareba evrokavSirisa da mezobeli qveynebis msgavs organizaciebTan da programebTan, gamocdilebisa da informaciis urTierTgacvla da am sferoSi erovnuli sakadro simZlavreebis ganviTareba;

iv. skriningis programis sargeblianobis Sesaxeb mosaxleobis informirebulobis amaRlebis xelSewyoba.

Standard Progress Report

GEO1R21A – Breast and Cervical Cancer Screening Programme

[danarTi 1]

skriningis erovnuli programis epidemiologia, Tbilisi, 2011

Breast Cancer Screening

January February March April May June July Augus t

Sept. Octob. Nov. Dec. Total Breast Cancer Screening 905 711 1240 1059 1236 999 1264 879 1250 1161 109 84 13912 National Screening Center 808 617 1132 992 1123 873 1106 749 1132 1070 11487 Tatishvili Medical Center 97 94 108 67 113 126 158 130 118 91 109 84 1295 Tbilisi Cancer Center 1025 Gudushauri Medical Center 51 Balneology Center 54

1.2 Performed Investigations

Type of Investigation N Percent(%)

Physical Investigation 13912 100% Mammography 13912 100% Ultrasound 3946 28.36% Cytology 466 3.35%

Type of Investigation Identified Abnormality

*

Distribution (%) (%) Portion among Total

(N=17141)

mamografia 2994 21.52% 21.52% ultrabgera 1099 27.85% 7.90% citologia 284 60.94% 2.04%

Cytology Result N %

Nonadequate 42 9.6% Benign 243 55.5% Atypical/Undifferentiated 37 8.4% Suspicious for Malignancy 28 6.4% Malignant 88 20.1%

Total 438 100%

Note: * Identified Abnormality Referrs to BIRADS 3, 4 and 5.

1.3 Abnormalities Identified by each Diagnostic Method and their Distribution

1.4 Cytology Results Distribution

1.1 Number of women screened by the Program


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Cervical Cancer Screening

January Februar

y

March April May June July Augus

t

Sept. Octob. Nov. Dec. Total

Cervical Cancer Screening 882 1038 1244 917 1195 1386 1394 840 1268 1155 109 84 14372National Screening Center 785 944 1136 850 1082 1260 1236 710 1150 1064 11877Tatishvili Medical Center 97 94 108 67 113 126 158 130 118 91 109 84 1197Tbilisi Cancer center 1239Balneology 59

Screening method N Percent

(%)PAP test 14372 100%

Colposcopy 2160 15.03%

Biopsy 252 1.75%

1.3 Distribution of the Atypical Pap test ResultsAtypical PAP Test Number Distibuti

on (%)

of

abnorm

(%)

abnorm

al PAP

results ASCUS 808 59.02% 5.62% ##### ##### ASC-H 116 8.47% 0.81% ##### ##### LSIL 272 19.87% 1.89% ##### #####HSIL 159 11.61% 1.11% ##### #####AGUS/AGC 7 0.51% 0.05% ##### #####Carcinoma 7 0.51% 0.05% #####

Total 1369 100.00% 9.53% ##### #####

1.5 Results of atypical Pap test after colposcopy investigations during 2010Cytological and Colposcopy

Diagnosis

Total N

ASCUS (n =725) 725 310 42.8% 146 20.1% 254 35.0% 15 2.1% 0 0.0%ASC-H (n = 97) 97 16 16.5% 38 39.2% 29 29.9% 9 9.3% 5 5.2%LSIL (n = 239) 239 69 28.9% 37 15.5% 128 53.6% 5 2.1% 0 0.0%AGUS/AGS (n=5) 5 1 20.0% 3 60.0% 1 20.0% 0 0.0% 0 0.0%HSIL (n = 130) 130 2 1.5% 22 16.9% 17 13.1% 77 59.2% 12 9.2%Carcinoma (n=1) 1 0 0.0% 0 0.0% 0 0.0% 0 0.0% 1 100.0%Total ( n = 1197)

1197398

33.2%246

20.6%429

35.8%106

8.9%18

1.5%1.6 Distribution of

Morphology Cytological and Colposcopy

Diagnosis

Total N

Normal Pap test (n=992) 992 338 34.1% 182 18.3% 123 12.4% 335 33.8% 13 1.3% 1 0.1%

1.2 Performed Investigations

1.1 Number of women screened by the Program

Invasive

Cancer

Number (%)

Norm

Number (%)

Not Satisfactory

Colposcopy

Number (%)

CIN1

Number (%)

CIN2,3

Number (%)

Invasive Cancer

Number (%)

Norm

Number (%)

Not

Satisfactory

Colposcopy

Number (%)

CIN1

Number (%)

CIN2,3

Number (%)

Polyp

Nimber (%)


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[danarTi 2] pacientTa kmayofilebis kvlevis Sedegebi

erovnuli skrining centris maria kaCinskas sax. filiali (varkeTili) N=100

mosazreba sruliad veTanxmebi

veTanxmebi

nawilobriv

veTanxmebi

ar veTanxmeb

i

sruliad ar

veTanxmebi

kmayofili var miRebuli samedicino momsaxurebiT

48 (48%) 51 (51%) 2 (2%) 0 0

didxans momiwia lodini servisis misaRebad

0 3 (3%) 4 (4%) 32 (32%) 61 (61%)

gamokvleva Catarda droulad, grafikis Sesabamisad 49 (49%) 45 (45%) 6 (6%) 0 0

eqimebi keTilganwyobili da yuradRebiani arian 72% 27% 1% 0 0

skrining centrSi momuSave administraciuli personali Zalian zereled mepyroba

0 2% 3% 6% 89%

eqimTan vizitis daniSvnas didi dro dasWirda

1 (1%) 3 (3%) 2 (2%) 23 (23%) 71 (71%)

ukmayofilo var miRebuli samedicino momsaxurebiT 0 1% 2% 20% 77%

skrining centrs rekomendacias gavuwevdi Cems ojaxis wevrebTan da megobrebTan 90% 9% 0 1% 0

samedicino personalma mirCia mimemarTa konkretuli samkurnalo dawesebulebisTvis an konkretuli eqimisTvis

1% 0 3% 7% 89%

gadaixadeT Tu ara momsaxurebis gadasaxadi? Tu gadaixadeT, miuTiTeT, ra saxis gamokvlevebisaTvis.

ara diax

mamografia 100% ultrabgeriTi gamokvleva

100%

Pap testi 100% kolposkopia 100% citologiuri gamokvleva

100%


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erovnuli skrining centris didubis filiali N=100


veTanxmebi nawilobri

v veTanxmebi

ar veTanxmebi

sruliad ar veTanxmebi


81% 16% 3% 0 0


0 3% 2% 73% 22%

gamokvleva Catarda droulad, grafikis Sesabamisad 23% 73% 3% 1% 0

eqimebi keTilganwyobili da yuradRebiani arian 98% 2% 0 0 0


0 1% 0 25% 74%


1% 1% 1% 47% 50%

ukmayofilo var miRebuli samedicino momsaxurebiT 0 0 1% 22% 77%

skrining centrs rekomendacias gavuwevdi Cems ojaxis wevrebTan da megobrebTan 96% 0 2% 2% 0


0 0 0 2% 98%


ara diax


100%


100%


1

1

1

Tbilisis onkologiis centri N=100


veTanxmebi

nawilobriv

veTanxmebi

ar veTanxmebi sruliad ar veTanxmebi


75% 21% 1% 2% 1%


0 5% 0 88% 7%

gamokvleva Catarda droulad, grafikis Sesabamisad 9% 84% 0 7% 0

eqimebi keTilganwyobili da yuradRebiani arian 85% 11% 0 1% 3%


0 3% 0 22% 75%


1% 3% 0 47% 49%

ukmayofilo var miRebuli samedicino momsaxurebiT 1% 2% 0 18% 79%

skrining centrs rekomendacias gavuwevdi Cems ojaxis wevrebTan da megobrebTan 23% 75% 0 1% 1%


0 2% 0 95% 3%


No Yes mamografia 99% 1% ultrabgeriTi gamokvleva

100%


100%


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1

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tatiSvilis samedicino centri N=100


veTanxmebi

nawilobriv

veTanxmebi

ar veTanxmebi sruliad ar veTanxmebi


96% 1% 2% 1% 0


7% 12% 7% 0 0

gamokvleva Catarda droulad, grafikis Sesabamisad 75% 5% 8% 5% 7%

eqimebi keTilganwyobili da yuradRebiani arian 93% 1% 3% 2% 1%


3% 0 2% 2% 93%


0 0 2% 2% 96%

ukmayofilo var miRebuli samedicino momsaxurebiT 1% 1% 2% 2% 94%

skrining centrs rekomendacias gavuwevdi Cems ojaxis wevrebTan da megobrebTan 94% 5% 0 0 1%


0 0 0 0 100%


ara diax


99% 1%

Pap testi 100%

kolposkopia 99% 1% citologiuri gamokvleva

100%

sul N=400


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rogor SeityveT skriningis programis Sesaxeb? sixSire procenti

avtobusze ganTavsebuli plakatiT 1 0.3% megobrebisgan 131 33.0% presiT 4 1.0% radioTi 2 0.5% sxva 63 15.9% televiziiT 196 49.4% sul 397 100.0%

dabrundebiT Tu ara gegmiur gasinjvaze, rogorc es Tqvens rekomendaciaSi aris miTiTebuli?

sixSire procenti

diax 389 97.7%

ara 9 2.3% sul 398 100.0%

ganmeorebiT gamokvlevaze mosvlaze uaris Tqmis mizezebi sixSire procenti

ukmayofilo var Catarebuli biofsiiT 1 0.11%

maqvs kerZo dazRveva 1 0.11%

Catarebuli histereqtomia 1 0.11%

vagrZeleb mkurnalobas onkologiur klinikaSi 1 0.11%

personalis zerele damokidebuleba da moZvelebuli aRWurviloba

1 0.11%

saSvilosnos da saSvilosnos yelis eqstirpacia 1 0.11%

Zalian dakavebuli var da vizitisTvis dro ar maqvs 1 0.11%

aRar mivekuTvnebi samizne jgufs 1 0.11%

momsaxurebis miRebas Zalian didi dro sWirdeba 1 0.11%

sul 9 100.0%

standard progress report 2010 - nsc · secvla da misi orientireba tbilisis samizne mosaxleobasi...

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