ТРАНСФОРМАЦИЯ СИСТЕМЫ ПРОТИВОТУБЕРКУЛЕЗНОЙ ПОМОЩИ В УСЛОВИЯХ ПАНДЕМИИ COVID-19: ОРГАНИЗАЦИОННЫЕ ВЫЗОВЫ И ЦИФРОВЫЕ РЕШЕНИЯ
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Пандемия COVID-19 существенно изменила как эпидемиологическую ситуацию по туберкулезу, так и работу противотуберкулезных программ, нарушив основные этапы оказания помощи – от выявления заболевания до начала лечения. В настоящем обзоре обобщены данные о влиянии пандемии на показатели выявления и смертности, лабораторную диагностику, маршрутизацию пациентов и организацию противотуберкулезной помощи в различных странах и регионах. Показано, что пандемический период сопровождался снижением числа зарегистрированных случаев, ростом смертности, уменьшением охвата лечением лекарственно-устойчивого туберкулеза и увеличением диагностических задержек. Особое место в обзоре отведено цифровым технологиям, рассматриваемым как один из ответов на организационные вызовы пандемии. Проанализированы возможности телемедицины, видеосопровождаемого лечения, мобильных приложений и чат-ботов для обеспечения непрерывности терапии, поддержки раннего выявления и оптимизации маршрутизации пациентов. Полученные данные позволяют заключить, что дальнейшая трансформация противотуберкулезной службы в постпандемический период должна быть ориентирована на повышение устойчивости системы, развитие пациент-ориентированных моделей ведения и интеграцию цифровых решений в повседневную фтизиатрическую практику
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