Tuberculosis as a public health problem

Tuberkuloza pluća je kronična upalna bolest uzrokovana specifičnim uzročnikom – bakterijom Mycobacterium tuberculosis. Infekcija je najčešće aerogena, inhalacijom bakterija koje se nalaze u kapljicama sline koje bolesnik kihanjem, kašljanjem ili govorom raspršuje u okolinu. Češća je pojavnost u lošim socijalnim i ekonomskim uvjetima kao i državama niskog standarda. Liječenje tuberkuloze je dugotrajno, traje 6-9 mjeseci, a katkad i do godine dana, uvijek uz kombinaciju više antituberkulotika koje preporučuje Međunarodna organizacija za suzbijanje tuberkuloze. U ovom istraživanju prikazana je pojavnost tuberkuloze u Koprivničko-križevačkoj županiji, usporedba pojavnosti tuberkuloze u Koprivničko-križevačkoj županiji s pojavnosti tuberkuloze u Republici Hrvatskoj, incidencija tuberkuloze po epidemiološkim ispostavama Koprivničko-križevačke županije, te po spolu. Istraživanjem je obuhvaćeno 457 ispitanika koji su oboljeli od tuberkuloze u razdoblju od 2000. do 2017. Godine. Podaci o oboljelima izvađeni su iz baze podataka Zavoda za javno zdravstvo Koprivničko-križevačke županije. Tijekom promatranog razdoblja zabilježen je negativan trend incidencije tuberkuloze, gdje je 2000. godine incidencija oboljelih iznosila 38 oboljelih na 100 000 stanovnika, a 2017. godine 8 oboljelih na 100 000 stanovnika. Ukupan broj oboljelih u razdoblju od 17 godina je 457/100 000 stanovnika. Pojavnost tuberkuloze u Koprivničko-križevačkoj županiji je u većini godina promatranog razdoblja veća u odnosu na incidenciju tuberkuloze u Republici Hrvatskoj. Koprivničko-križevačku županiju smo podijelili na njezine ispostave (Koprivnica, Križevci i Đurđevac) te smo iz toga zaključili kako je najveća incidencija zabilježena 2004. godine u Koprivnici i iznosi 25 oboljelih na 100 000 stanovnika, dok je u Đurđevcu te iste godine 12 oboljelih, a u Križevcima samo 6 oboljelih. Kad podatke podijelimo po spolu tada dolazimo do zaključka da je oboljelo više muškaraca nego žena. Procjenjuje se da je oko trećine svjetske populacije u ovome trenutku zaražena uzročnikom tuberkuloze, stoga je najvažnija zadaća visoko-educiranih medicinskih sestara provesti sve mjere u prevenciji njezina širenja. Navedeno uključuje cijepljenje protiv tuberkuloze (BCG cjepivo), korištenje kemoprofilakse latentne tuberkuloze u osoba s povećanim rizikom za razvoj bolesti te zdravstveno prosvjećivanje o tuberkulozi.Tuberculosis is a chronic inflammatory lung disease caused by specific bacterial pathogen Mycobacterium tuberculosis. Infection is most commonly spread aerogenically by the inhalation of bacteria contained in the droplets dispersed during sneezing, coughing and speech. The disease is more frequent in poor social and economic conditions, as well as in low-income countries. Treatment of tuberculosis is protracted; it lasts 6-9 months (sometimes up to one year) and a combination of several antituberculotic drugs are used, as recommended by the International Organization for combating tuberculosis. This study aims to describe the incidence of tuberculosis in the Korpivnica-Križevci County, as well as to compare the incidence in the aforementioned county with the incidence of tuberculosis in the Republic of Croatia, with the incidence of tuberculosis in sublocal epidemiological administrative centres of the Koprivnica-Križevci County, as well as according to gender. The study included 457 examinees suffering from tuberculosis in the period between 2000 and 2017. Information about patients originated from the database of the Institute for Public Health of the Koprivnica-Križevci County. A negative trend in the incidence of tuberculosis was recorded during the observed period, where in 2000 the incidence of tuberculosis was 38 patients on 100,000 inhabitants, while in 2017 that number was 8 patients on 100,000 inhabitants. The total number of patients during 17 years was 457/100 000 inhabitants. The occurrence of tuberculosis in Koprivnica-Križevci county has been higher in a larger part of the observed period when compared to the incidence of tuberculosis in the Republic of Croatia as a whole. We divided Koprivnica-Križevci county into different units, which helped us to conclude that the highest incidence was recorded in 2004 in Koprivnica (25 patients on 100 000 inhabitants), while in Đurđevac 12 patients were noted in the same year, and only 6 sufferers in Križevci. When we analyse the data by gender, we can conclude that more men were affected than women. It is estimated that about a third of the world’s population is currently infected with the agent of tuberculosis; hence, the most important task of the highly educated nurses is to carry out all measures for the prevention of disease dissemination – including vaccination against tuberculosis, chemoprophylaxis of latent tuberculosis in individuals with an increased risk for disease development, and increasing health promotion endeavours