DEFINING THE INDEX OF SUSPICION OF UROGENITAL TUBERCULOSIS IN DOCTORS SPECIALIZING IN VARIOUS FIELDS

Abstract

Polymorphism of clinical manifestations and absence of pathognomic symptoms are typical of urogenital tuberculosis. Since anti-microbial agents are widely used (fluoruquinolones, amikacin, rifampicin), it is more difficult to verify the diagnosis by pathomorphologic and bacteriological methods. The index of suspicion and certain required minimum level of knowledge on urogenital tuberculosis are crucial for its early diagnostics.Materials and methods. In order to assess the level of knowledge in doctors specializing in different fields (urologists, gynecologists, general practitioners, phthisiologists) about specific symptoms and early diagnostics of urogenital tuberculosis and to evaluate the level of their awareness of this disease, 265 specialists had a test in the form of a questionnaire. To define preferences of specialists when choosing specific therapy of infectious inflammatory disorders of the urogenital system, the answers to the questionnaire given by 2 groups of doctors were analyzed, Group 1 (103 persons) included urologists, gynecologists and phthisiologists from medical units of Novosibirsk Region and city of Novosibirsk, Group 2 (298 persons) included interns and residents of Novosibirsk State Medical University by the Russian Ministry of Health.Results. There was no significant difference between the level of knowledge about urogenital tuberculosis among the specialists: urologists, gynecologists, and general practitioners gave the right answers in 59.2-63.7% of cases; phthisiologists had a better level of knowledge and 77.2% of their answers was right. In every third case, the choice of anti-microbial agents for empiric therapy of acute and chronic cystitis was not the best option regarding the drug resistance and inhibiting action against M. tuberculosis.Conclusion: The results of the questionnaire survey showed the low level of knowledge about urogenital tuberculosis among the specialists of general medical services (urologists, gynecologists, general practitioners). The high number of antibacterial agents with tuberculostatic action which were mentioned as drugs for the empiric treatment of urogenital disorders reflects the fact that importance of urogenital tuberculosis is underestimated by the specialists.

Keywords

• туберкулез
• внелегочный туберкулез
• уровень настороженности
• (index suspicion)
• инфекция мочевыводящих путей
• эмпирическая терапия
• ранняя диагностика