An operational study of the effectiveness of early diagnosis in female reproductive disorders associated with genital tuberculosis

Objective. Based on the amended list of risk factors for genital tuberculosis, to conduct an operational study of active identification of women at risk of reproductive disorders associated with genital tuberculosis. Material and methods. The study was conducted at the Research Center for Problems of Family Health and Human Reproduction (Irkutsk), G.D. Dugarova Republican Tuberculosis Clinical Hospital (Ulan-Ude), and Republican Clinical Gynecological Hospital (Ulan-Ude) in 2011-2017. The study analyzed the incidence of female genital tuberculosis in 2011 among patients of maternity clinics of City Polyclinic No. 6 and City Polyclinic No. 4. Obstetrician-gynecologists providing outpatient care at the City Polyclinic No. received a course of six once-monthly lectures. The developed algorithm for genital tuberculosis risk stratification was introduced with subsequent referrals of patients to G.D. Dugarova Republican Tuberculosis Clinical Hospital, Ulan- Ude since the beginning of February 2012. After the intervention, the incidence of genital tuberculosis was assessed in the control and experimental health care facilities (2015). Results. An extended list of risk factors for genital tuberculosis in women with reproductive disorders has been proposed and introduced into clinical practice. The list included new and updated criteria: chronic pelvic pain, a history of failed IVF attempts, specific types of menstrual disorders, temporary criteria for treatment failure of menstrual dysfunction and pelvic inflammatory diseases. The operational study estimated the implementation of an algorithm for active identification of risk factors of female reproductive disorders associated with genital tuberculosis, which resulted in 3.6-fold improvement of diagnosis of genital tuberculosis in outpatient settings. Conclusion. The operational study of the active introduction of the extended list of risk factors in outpatient settings increased the effectiveness of early diagnosis of female reproductive disorders associated with genital tuberculosis: 14 out of390 (3.6%), which corresponds to 0.5 per 100 000population versus zero incidence without intervention.

operational study, risk factors, genital tuberculosis, genital tuberculosis, reproductive disorders