MAIN RISK FACTORS OF DEVELOPING EARLY RESPIRATORY TUBERCULOSIS RELAPSES

Aim. To study the causes of developing early relapses of respiratory tuberculosis while comparing patients’ data with those of subjects clinically cured from respiratory tuberculosis and having no early relapses later. Materials and methods. Three hundred and forty four cases of early respiratory tuberculosis relapses (ERTR) in patients aged 18 and older constantly living in Moscow were studied. Results. The following 7 factors significantly influencing their development were singled out: drug resistance of tuberculous mycobacteria in initial disease, incomplete basic chemotherapy course, absence of antirecurrent courses of treatment, intercurrent diseases, chronic alcoholism, stable disability, absence of permanent place of employment and as a result, low material income. Among the mentioned factors, medical factors played a great role in development of early relapse, social ones – a lesser role. Drug resistance of tuberculous mycobacteria in initial disease and stable disability caused by severe associated diseases had the most pronounced effect on their development. Thus, a significant role in development of early relapses belongs to endogenous reactivation of tuberculous process in respiratory organs. Analysis of character and frequency of risk factors of developing respiratory tuberculosis relapses showed that they are influenced by not a separate factor but their combination. Three and more medical and social factors combined in one patient raise the probability of developing early relapse up to 93%. Conclusion. For phthiciatric practice, it is necessary to form risk groups from clinically cured socially disadapted persons with drug resistance of tuberculous mycobacteria in initial disease associated with severe chronic concomitant diseases and their follow-up at antituberculous dispensary during the first five years from the moment of ascertaining clinical recovery with obligatory antirecurrent course of treatment and sanatorium rehabilitation, considering this contingent as having a great threat of developing early respiratory tuberculosis relapses.

Early relapses, risk factors, probability of development