Charakterisierung der Tuberkulosesituation in der Russischen Föderation : Analyse der epidemiologischen Lage und der Probleme in der Tuberkulosekontrolle auf föderaler Ebene und in der Autonomen Republik Tuva

Russia and the other successor states of the former Soviet Union suffer from high numbers in tuberculosis prevalences and incidences, the problem of tuberculosis spread is aggravated by rising rates of multidrug resistance. Information for this thesis was gathered by literature research and by analysis of tuberculosis surveillance data from the Russian Federation as well as from one high burden region, the Autonomous Republic of Tuva. The thesis highlights the main reasons for the current tuberculosis problem and for difficulties to efficiently implement DOTS. Russia's tuberculosis control system is based on active case finding. Microbiological analysis and standardized drug regimens still need to be improved. Therapy failure often results in prolonged treatment. The thesis puts forward arguments for a more flexible discussion of efficient ways of tuberculosis control in Russia. The special situation in Russia with high rates of multidrug resistant tuberculosis requires an adapted implementation of DOTS and of the WHO recommendations for tuberculosis control.