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Historical aspects to fight Tuberculosis in Georgia

 

Tuberculosis is as old as mankind

 French School of the History of Medicine

 

The first traces of tuberculosis in Georgia were found in the fossils of VI-VII cc. B.C., which revealed tuberculosis spondylitis. From the medical sources tuberculosis was first mentioned in Kananeli “Ustsoro Karabadini” in X century, afterwards in the old Georgian medical manuscripts. Here the terminology of lung tuberculosis, main signs, methods of diagnostics and treatment were described. In the old medical manuscripts tuberculosis is nominated with two basic terms “Sili” and “Firtuisa Sikluke”. The term consumption was introduced later.

The materials of the Imperial Medical Society of the Caucasus and the Society of the Caucasus to Fight Tuberculosis contain rich data about tuberculosis. The Imperial Medical Society of the Caucasus was created on 5 April, 1864. In 1904 the society worked in several directions, namely it organized sanatoriums, TB ambulatories, society departments and the “White Flower Day” annually for fundraising. The “White Flower Day” was celebrated until 1917. Afterwards it was changed with “three-day celebration of tuberculosis", which was held until 1928.

In 1918-1921, the period of independent Georgia, the attention of the Government was turned to epidemics, including consumption. During this period Ioseb Abakelia, the founder of Phthisiatry, came with an initiative to establish a Sanitary Institute being an active fighter against epidemic diseases.

Since 1921 the organized fight against tuberculosis started with the leadership of the government. The work against tuberculosis involved creation of the networks, staff mobilization, elaboration of the standards of detection, diagnosis and treatment of the patients, prevention courses, creation of the system of statistics on tuberculosis. In 1930 the Scientific-Research Institute of tuberculosis was established.

In the 1960-70s in relation to the significant improvement of epidemiological situation of tuberculosis, the role of the institute, as of a scientific phthisio-pulmonological center, increased. Respectively, since 1990 the scientific-research institute of Tuberculosis was changed with the institute of Phthisiatry and pulmonology. During the existence of the institute a number of scientific studies were done, a big part of which was put in practice. A wide specter of activities is revealed in the scientific proceedings of the institute, in the materials of the congress and symposia of Georgia and the South Caucasus. During this period, 35 monographs, manuals, and reference books were published. The best determiner of the results of fighting against tuberculosis was epidemiological situation of tuberculosis. In 1970-90s, as a result of conducting anti-tuberculosis activities, morbidity with tuberculosis in the republic has decreased from 56 to 28.3, incidence from 334 to 140.7, and mortality from 10.9 to 4.91 (per 100 000 population).

The ongoing socio political events and dissolution of the healthcare system in Georgia in 1991-94, resulted in the drastic deterioration of the epidemiological situation. Fight against tuberculosis did not practically exist. Unsystematic diagnostics and treatment of the people infected with tuberculosis continued through inertia. Due to all this fight against tuberculosis was considered as a priority and at the beginning of 1995 with the support of the World Health Organization, three pilot projects, compliant to the modern strategy, were implemented in three cities of Georgia (Tbilisi, Gori, Rustavi). During this period a state programme to fight tuberculosis was elaborated at the Ministry of Labor, Health and Social Affairs of Georgia. Its implementation started countrywide since August 1995. This programme is totally based on the new DOTs strategy to fight tuberculosis.


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