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INFECTIOUS DISEASES
Deterioration of sanitary-epidemiologic and disinfection services has led to anti-sanitary, and spread of diseases, carried via water: dysentery, typhoid, malaria, tuberculosis. Frequency of tuberculosis casualties increased from for 349% from 1993 till 1998, and malaria - by 150 times from 1990 till 1997.
Table 4. Population morbidity with infectious diseases per 100.000 persons
| Morbidity |
1991 |
1992 |
1993 |
1994 |
1995 |
1996 |
1997 |
1998 |
1999 |
| Tuberculosis |
39.61 |
30.08 |
11.74 |
15.68 |
32.24 |
28.10 |
35.45 |
40.8 |
42.0 |
| Syphilis |
1.70 |
2.90 |
4.93 |
7.86 |
14.75 |
19.16 |
22.38 |
16.3 |
8.6 |
| Malaria |
5.50 |
7.27 |
11.14 |
42.39 |
106.0 |
282.71 |
497.7 |
322.7 |
222.0 |
| Diphtheria |
0.09 |
0.29 |
12.20 |
33.53 |
77.38 |
24.98 |
11.96 |
2.8 |
1.0 |
| Tetanus |
0.06 |
0.02 |
0.04 |
0.05 |
0.02 |
0.00 |
0.00 |
0.04 |
|
| Poliomyelitis |
2.15 |
0.09 |
0.25 |
0.46 |
0.00 |
0.00 |
0.02 |
0.00 |
0.00 |
| AIDS |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
0.00 |
(Sources: WHO, Ministry for Health Care, Sate Statistics Agency)
Poor quality of drinking water causes enteric infections spread.
According to the data of Republican sanitary-epidemiologic station 55% of the population have access to running water. 80% of water pipes leak, and water in them becomes polluted. Only in large cities there are taken measures on improvement of drinking water quality. There is shortage of coagulants and chlorine for water treatment. Nearly half of the population in rural area use water from open sources, and this causes break-outs of epidemics because of lack of appropriate control.
Existing programs surely promote public health protection, prophylactics of diseases, and better use of resources. Their goals meets world practice and receive support from international organizations, such as WHO, UNICEF, UN population fund, and UN programme of AIDS prevention. Ministry for Health Care under assistance of WHO and UNICEF regularly conduct national immunization days as a result of which virus of poliomyelitis reduced to 0.69 casualties, diphtheria - to 2.8 casualties per 100 000 persons. However, tuberculosis casualties increased from 1647 in the year 1996 to 2553 in 1999. The problem of tuberculosis identification and treatment has become the priority. Another priority direction of health care is combat to malaria. Break-out of malaria took place in areas bordering on Afghanistan. Rebels, who came back, became the carriers of malaria. In 1997 there were registered 30054 casualties of this disease in Kurghan-Tybe area, among them P.falciparum (tropical malaria) made 16%. As a result of anti-malaria campaign conducted under support of international organizations, in 1998 malaria casualties reduced to 19361. The conducted disinfection in living spaces has given good results. There was disinfected 25 million m? of the living rooms and livestock buildings. For one year the level of morbidity was reduced almost twice. For combating to malaria and other tropical diseases in Tajikistan there was established the Center on combating to tropical diseases. In 1998 anti-malaria programme was supported by the Government of Japan ($1 million), and in 1999-2000 - by European Union ($1million).
Poor awareness of the population on genital diseases and diseases carried via blood leads to spread of theses diseases and HIV, especially among drug abusers. HIV/AIDS, along with narcomania presents real threat for future generations. One casualty of non-precaution posses threat for several generations of people. Also the fact of narcomania rejuvenation provides danger. Research works conducted by the Center on HIV/AIDS prophylactics and combat in Dushanbe showed that 22% of pupils and 8.2% of students tried drugs. At the moment 5 HIV infected persons are under control in the Republic of Tajikistan. In two case the cause of infection was syringe narcomania, and in three others - coitus. There are no infected children. Registered cases, however, do not reflect real scene of HIV-infections spread in Tajikistan. In the Republic of Tajikistan there is shortage of laboratory equipment and medical diagnosticums for identification of HIV-carriers, even among donors. Available laboratory equipment in diagnostic laboratories requires modernization. In Tajikistan the main documents on AIDS prophylactics and combat is the Law "On AIDS prophylactics". In 1997 there was approved the national program on HIV/AIDS prophylactics and combat. With the issues on AIDS prevention there is occupied UN theme group consisting of UNDP, UN programme on combat to AIDS, UNICEF, WHO, WB, UN population fund and drugs control and criminality prevention. The work plan of the strategy includes a number of activities under UN support, such conducting workshops, introduction of the materials into school programme, publishing of textbooks, training on clinique and diagnostics, epidemiological control, information dissemination via mass media, holding the World Day on combat to AIDS, interviewing youth, prophylactics of HIV/AIDS and genital diseases. etc.
· Republican Center on prophylactics and combat to HIV/AIDS, under financial support of UN theme group members, conducted workshops on HIV/AIDS diagnostics and treatment for 25 specialists on health care in the first half of 2000.
· The earlier abolished district centers on prophylactics and combat to AIDS has been rehabilitated.
· Published and disseminated four types of booklets in the circulation of 20.000 examples containing information on AIDS and prophylactics, as well as posters and calendars.
In Dushanbe there are opened two points of trust for work with drug abusers, conducted anonymous talks and consulting. In 2000 there were 140 visitors. In the context of shortage of tests no identification of HIV/AIDS availability were conducted.
(Republican Center)
Tajikistan, Report on Human Development, 2000, UNDP
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