saqartvelosi tuberkulozis kontrolis erovnuli gegmis proeqti arcil salayaia archil salakaia, md. mph...
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saqarTveloSi tuberkulozis kontrolis erovnuli gegmis
proeqti
arCil salayaia
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
mizani
saqarTveloSi tuberkulozis kontrolis 5-wliani gegmis (2007-2011) mizania sikvdilobis, avadobisa da infeqciis gavrcelebis Semcireba da medikamentebisadmi rezistentobis ganviTarebis prevencia, riTac Semcirdeba tuberkuloziT gamowveuli social-ekonomikuri tvirTi ojaxebsa da sazogadoebaze
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
amocanebi
1. maRali xarisxis DOTS strategiis danergvis Semdgomi gafarToeba-gaZliereba
2. multirezistentuli tuberkulozis mkurnalobisaTvis aucilebeli pirobebis Seqmna da DOTS + strategiis danergva
3. tuberkulozis kontrolis integracia jandacvis sistemis reformaSi
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
amocanebi (gagrZeleba)
4. farTo TanamSromlobis uzrunvelyofa tuberkulozi/aiv koinfeqciis kontrolis erToblivi RonisZiebebis gansaxorcieleblad
5. pacientebisa da sazogadoebis Tanamonawileoba tuberkulozis kontrolSi da tuberkulozTan asocirebuli stigmis Semcireba
6. tuberkulozTan dakavSirebuli kvlevebis mxardaWera
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
misaRwevi indikatorebi
2007 wlisTvis
• gamovlenis maCvenebeli unda iyos 70%-ze meti;
• warmatebuli mkurnalobis maCvenebeli unda iyos 85%-ze meti
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
misaRwevi indikatorebi (gagrZeleba)
2010 wlisTvis
• multirezistentuli tuberkuloziT daavadebuli yvela pacientisaTvis xelmisawvdomi unda iyos DOTS + -iT mkurnaloba;
• multirezitentuli tuberkulozis warmatebuli mkurnalobis maCvenebelma unda miaRwios 60%-s
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
misaRwevi indikatorebi (gagrZeleba)
2011 wlisTvis
• unda daiwyos tuberuloziT avadobis kleba;
• unda daiwyos multirezistenuli tuberkuloziT avadobis kleba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
maRali xarisxis DOTS strategiis danergvis Semdgomi gafarToeba-
gaZliereba (amocana 1)
1. tuberkulozis kontrolis politikuri mxardaWera
2. tuberkulozis SemTxvevaTa gamovlena
3. standartuli mkurnaloba da pacientis mxardaWera
4. tubsawinaaRmdego medikamentebiT momaragebisa da marTvis efeqturi sistema
5. monitoringis sistema da Sedegebis Sefaseba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozis kontrolis politikuri mxardaWera
• tuberkulozis kontrolis mzardi da stabiluri finansuri uzrunvelyofa
• tuberkulozis kontrolis koordinacia
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozis SemTxvevaTa gamovlena
naxvelis nacxis mikroskopuli gamokvleva
• baqteriologiur laboratoriaTa reorganizacia-optimizacia
• laboratoriaTa da naxvelis Semgrovebeli punqtebis aRWurva da momarageba
• gamosakvlevi masalis transportireba (naxvelis Semgrovebeli punqtebidan baqterioskopul laboratoriebSi, baqterioskopuli laboratoriebidan ki - erovnul referens laboratoriaSi)
• xarisxis kontrolis ganxorcieleba erovnuli referens laboratoriis mier, laboratoriis TanamSromlebis uwyveti swavlebis uzrunvelyofa janmo-s rekomendaciebis Sesabamisad
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozis SemTxvevaTa gamovlena (gagrZeleba)
kulturaluri gamokvleva da tubsawinaaRmdego wamlebisadmi mgrZnobelobis gansazRvra
• I etapi, 2007-2008ww, baqterioskopulad da klinikurad dadgenili tuberkulozis yvela SemTxvevis kulturaluri dadastureba
• II etapi, 2010-2011ww, kulturaluri gamokvleva tuberkulozze yvela eWvmitanilis da tubdaavadebulisa
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozis SemTxvevaTa gamovlena (gagrZeleba)
SemTxvevaTa aqtiuri gamovlena
• filtvis aqtiuri tuberkuloziT daavadebulTan (mgb +) kontaqtSi myofi pirebi
• sasjelaRsrulebis dawesebulebebSi myofi pirebi
• aiv-inficirebuli pirebi
• wvevamdelebi
• saWiroebis SemTxvevaSi mosaxleobis sxva SerCeuli jgufebi (mag.: iZulebiT gadaadgilebuli pirebi da intravenuri narkomanebi)
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
standartuli mkurnaloba da pacientis mxardaWera
• standartuli mkurnaloba uSualo meTvalyureobis qveS (DOT)
• pacientze orientirebuli samedicino daxmareba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tubsawinaaRmdego medikamentebiT momaragebisa
da marTvis efeqturi sistema
• tubsawinaaRmdego medikamentebis Sesyidvisa da ganawilebis dagegmva
• tubsawinaaRmdego medikamentebis gavrcelebis samarTlebrivi regulacia
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
registracia-angariSgebis sistema
• qveyanaSi unda arsebobdes erTiani unificirebuli registracia-angariSgebis sistema (maT Soris samoqalaqo da penitencialur seqtorSi)
• qveyanaSi unda arsebobdes tuberkulozis registrirebuli SemTxvevebis erTiani erovnuli monacemTa baza
• laboratoriuli Sedegebis angariSgebis integrireba tuberkulozis registracia-angariSgebis sistemaSi
• angariSgebis eleqtronuli sistemebis danergva
• TiToeuli samedicino dawesebulebis (maT Soris, kerZo praqtikis eqimebis) mier tuberkulozis yvela SemTxvevis erTiani monacemTa bazisaTvis savaldebulo Setyobinebis uzrunvelyofa
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
DOTS plus strategiis danergva(amocana 2)
1. DOTS + da misi danergvis etapebi 2. mkurnaloba3. laboratoria 4. infeqciis kontroli 5. swavleba 6. zedamxedveloba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
DOTS + da misi danergvis etapebi
2006 wlisTvis
• MSF-is mxardaWeriT iwyeba piloturi proeqti
• organizaciebis ICRC da GOPA/KfW mxardaWeriT iwyeba piloturi proeqti penitencialur sistemaSi
• tuberkulozis erovnuli programa waradgens ganacxads “mwvane Suqis komitetSi” globaluri fondis proeqtiT dafinansebuli DOTS plus mkurnalobis gansaxorcieleblad
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
DOTS + da misi danergvis etapebi
2007 wlisTvis
• unda damTavrdes tuberkulozisa da filtvis daavadebaTa erovnuli centris axali Senobis mSenebloba da arsebuli Senobis rekonstruqcia
• globaluri fondis proeqtiT dafinansdeba 50 multirezistentuli pacientis mkurnaloba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
2008-2010 wlebisTvis
• globaluri fondi daafinansebs 100 multirezistentuli pacientis mkurnalobas
• saxelmwifom unda uzrunvelyos finansuri mxardaWera, raTa daifaros sxvaoba donoruli proeqtebiT uzrunvelyofil mkurnalobasa da realur saWiroebas Soris (300 pacienti wliurad)
DOTS + da misi danergvis etapebi
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
multirezistentuli tuberkulozis mkurnalobis principebi
• individualizirebuli mkurnaloba meore rigis antituberkulozuri medikamentebiT
• uSualo meTvalyureoba wamlis TiToeuli dozis miRebaze
• gverdiTi movlenebis sakoreqcio medikamentebi
• stacionari (qirurgiuli ganyofilebis CaTvliT), romelSic tardeba mkurnaloba, unda akmayofilebdes specialur standartebs
• ambulatoriuli mkurnalobisTvis unda arsebobdes gamarTuli infrastruqtura
• pacientebisa da maTi ojaxebisTvis mxardaWera
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
DOTS + laboratoriuli momsaxureba
• simZlavreebis gazrda, raTa uzrunvelyofil iyos yvela eWvmitanilisa da daavadebulis baqteriologiuri gamokvleva
• II rigis tubsawinaaRmdego medikamentebis mimarT mgrZnobelobis testis danergva
• kulturaluri gamokvlevisa da mgrZnobelobis ganmsazRvreli avtomatizebuli sistemebis danergva
• infeqciis kontrolis gaumjobeseba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozis kontrolis integracia jandacvis sistemis reformaSi
(amocana 3)
• tuberkulozis erovnuli programis statusi da organizaciuli struqtura
• tuberkulozis kontroli penitencialur sistemaSi
• pirveladi jandacvisa da tubsamsaxurebis integracia
• samedicino ganaTleba da gadamzadeba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
erovnuli programis struqtura da funqciebi
centraluri done
regionaluri done
programis Sefasebis
da dagegmvis samsaxuri
tuberkulozisa da filtvis daavadebaTa erovnuli centri
erl centraluri afTiaqi da
uzrunvelyofis samsaxuri
marTvis samsaxuri sauniversiteto, referaluri klinika
erovnulimonacemTa
baza
supervizia daadamianuriresursebis
ganviTareba
stacionari ambulatoria samecnierokvlevebis
koordinaciissamsaxuri
reg. koordinatori reg. dispanseri (sawolebiT an sawolebis gareSe).
tuberkuloziskoordinatori penitencialuripenitencialur sistemasistemaSi
kabinetidispanseri pjr
tuberkulozis ganyofileba fsiqonevrologiur saavadmyofoSi
raionuli done
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozi/aiv koinfeqciis mkurnalobisa da kontrolis erToblivi
RonisZiebebis ganxorcieleba(amocana 4)
• tuberkuloziT gamowveuli tvirTis Semcireba aiv/SidsiT daavadebulTa Soris
• aiv-infeqciiT gamowveuli tvirTis Semcireba tuberkuloziT daavadebulTa Soris
• tuberkulozisa da aiv/Sidsis koinfeqciis mkurnaloba
• aiv/tuberkulozis erToblivi RonisZiebebis monitoringi da Sefaseba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
pacientebisa da sazogadoebis Tanamonawileoba tuberkulozis kontrolSi
da tuberkulozTan asocirebuli stigmis Semcireba
(amocana 5)
• sazogadoebis ganswavlis strategia
• sazogadoebis monawileoba
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases
tuberkulozTan dakavSirebuli kvlevebis mxardaWera
(amocana 6)
• operaciuli kvlevebi
• samecniero kvlevebi saqarTveloSi globaluri miznebis konteqstSi
Archil Salakaia, MD. MPH
Executive Director.National Center for Tuberculosis and Lung Diseases