Among infectious diseases, hepatitis, HIV infection, tuberculosis and transmitted diseases are characterized by a high incidence rate and numerous complex negative social consequences. sexually.
Hepatitis – This inflammatory disease liver, caused by viruses (A, B, C, D, E, C). Hepatitis B and hepatitis C have the greatest social significance. The hepatitis B virus is transmitted through contaminated blood or blood products. Transmission of the virus is especially common among people dependent on psychoactive (injecting) substances, people who provide and consume sexual services, and homosexual men.
A pregnant woman infected with the virus passes it on to her baby during childbirth. The risk of infection is increased for medical personnel, working with blood, as well as for prisoners in penitentiary institutions. For hepatitis C, the main route of transmission is blood transfusion.
The manifestations of hepatitis B and C are almost the same: general malaise, lack of appetite, nausea, vomiting, increased body temperature. These symptoms then soften or disappear. However, the disease develops, as evidenced by darkening of the urine and the development of jaundice. If left untreated, the patient develops liver failure, which has a high mortality rate. Prevention of hepatitis B and C involves careful monitoring of the blood transfusion procedure, and for hepatitis B, vaccination against it.
The next disease in this group is HIV infection. The human immunodeficiency virus penetrates lymphocytes and destroys them. As a result, immunity deficiency develops, called acquired immunodeficiency syndrome (AIDS), as well as diseases caused by this syndrome.
Transmission of HIV infection requires contact with body fluids containing infected cells or viruses. These include blood, semen, vaginal secretions, cerebrospinal fluid and breast milk. The virus can be transmitted in several ways: through sexual contact with an infected person, through an injection with a contaminated needle or through a transfusion of contaminated blood, as well as from an infected mother to her child during childbirth and through breast milk.
Susceptibility to HIV infection increases with existing damage to the skin and mucous membranes, caused either by vigorous sexual intercourse or by an existing disease (herpes, syphilis). The virus is not transmitted by airborne droplets (by coughing and sneezing) or by vector-borne transmission (by mosquito bites). There are isolated cases of transmission of HIV infection from an infected dentist to a patient.
The leading sign of the onset of the disease is the reproduction and circulation of HIV in the blood. This is observed immediately after contact with the patient. External signs The onset of the disease is expressed differently. Some infected people experience a primary reaction in the form of fever, general discomfort, rash and enlarged lymph nodes. Then these symptoms disappear, and there is an increase in body temperature that does not have any clear reason. Expanded clinical picture occurs months and years after infection. It consists of weight loss, general malaise, recurrent diarrhea, anemia, and fungal infection in the oral cavity.
AIDS itself begins from the moment when the number of lymphocytes in the blood decreases by 20 times compared to the norm or when opportunistic infections caused by microorganisms begin to develop, not causing diseases in people with normal immunity. Such infections include fungal inflammations, candidiasis oral cavity, esophagus and vagina.
Very often the cause of death of patients is pneumonia caused by a fungus. Chronic infection caused by Toxoplasma, present in human body since childhood, occurs less frequently. It affects the brain, impairing memory, reducing concentration and reducing the speed of information processing. In HIV-infected patients, tuberculosis is much more severe, practically untreatable with antibiotics and often causes death.
Loss of motor coordination, loss of the ability to walk and stand are the result of progressive multifocal leukoencephalopathy ( viral infection brain), and blindness is the result cytomegalovirus infection. Oncological diseases of AIDS patients are most often represented by Galoshi's sarcoma, cervical cancer, and in homosexual men - rectal tumors.
Despite the fact that in last years developed and implemented in clinical practice medications that reduce the severity of HIV infection and AIDS are the most effective method is prevention, which includes methods of a social nature.
Tuberculosis – airborne infection, caused by Mycobacterium tuberculosis. The incidence of tuberculosis largely depends on social factors. This is manifested by the wave-like nature of the incidence rate.
Creation of anti-tuberculosis antibiotics and health social activities led to a very significant reduction in the incidence of this pathology. However, since the late 80s. last century, almost all over the world (even in countries with a high level of healthcare) there has been an increase in the incidence of tuberculosis. It is believed that in this process, factors such as the formation of megacities, an increase in the volume of migration and the number of homeless people, and deterioration of the environmental situation are of primary importance.
IN Russian Federation The incidence of tuberculosis is 80 per 100 thousand population. Every year in Russia 20 thousand people die from tuberculosis (more than from all infectious diseases combined).
Tuberculosis is transmitted by airborne droplets. Mycobacteria can remain viable at room temperature for several hours. They are transmitted from an affected mother to the fetus before or during labor by aspiration or ingestion of infected amniotic fluid. In most cases, tuberculosis bacteria are destroyed by cells immune system. However, some of them are not destroyed, but are fixed by macrophages.
Bacteria do not manifest themselves functionally, but, provided the body’s immunity is weakened, they begin to actively multiply. This is how tuberculosis develops in 80% of cases. Active TB usually begins in the lungs (pulmonary TB). Its foci in other organs (extrapulmonary tuberculosis) arise after this as a result of the spread of mycobacteria through the blood.
One of the early manifestations of tuberculosis is a cough with a small amount of yellow or green sputum in the morning. As the disease progresses, the amount of sputum increases. It is stained with a small amount of blood. A common symptom is profuse sweating: the patient wakes up in profuse cold sweat, due to which it is necessary to change sleeping clothes and bed linen.
Shortness of breath develops as a consequence of the presence of pleural cavity air or pleural effusion, which interfere with the expansion of the lung during breathing.
Extrapulmonary tuberculosis most often affects the kidneys, bones, bladder and in the picture of the disease signs of pathology of these organs appear. In men, the infection can affect prostate gland, seminal vesicles and epididymis, and in women - the ovary and the fallopian tubes, causing infertility.
Often the infection spreads to the joints (mainly large joints - hip and knee), skin, intestines, adrenal glands, walls of blood vessels, and the pericardium lining of the heart. Extremely dangerous tuberculous meningitis, which affects children under five years of age and the elderly. It is manifested by constant headache, nausea and drowsiness, turning into a coma, as well as sudden tension occipital muscles. In children, the spine is often affected, which is accompanied by severe pain.
Sexually transmitted diseases – those that are transmitted to each other through sexual contact. They are the most common infectious diseases in the world. At the end of the 80s. last century, after some stabilization, a sharp rise in the incidence of diseases belonging to this group began. Let us characterize the main ones.
Syphilis is an infectious disease caused by the spirochete pallidum. The pathogen enters the body through mucous membranes and skin. The first manifestations of the disease most often appear after 3–4 weeks (less often after 1–13 weeks). The disease occurs in several stages.
In the primary stage, a painless ulcer (chancre) appears at the site of entry of the pathogen. It is localized on the head of the penis, vulva, vagina, in the area anus, on the mucous membrane of the rectum, on the lips, tongue, on the mucous membrane of the oral cavity. In other parts of the body, chancre forms much less frequently. It is a small sore that does not bleed or hurt. When you scratch it, a few drops of clear liquid appear on the surface, which is extremely contagious. Proximal to the ulcer The lymph nodes increased in size, firm consistency and painless. After 2–3 weeks, the chancre disappears, giving the impression of recovery.
The secondary stage, which begins 6–12 weeks after infection, is characterized by the appearance of a generalized skin rash, enlarged lymph nodes throughout the body, inflammation of the eyes, development of ulcers in the mouth, damage to bones and joints, liver, kidneys and brain. In moist areas of the skin (in the corners of the mouth, vulva), condylomas lata can develop, which are a source of infection. The latent stage can last from several years to several decades. It is characterized by the absence of any manifestations of the disease.
The tertiary stage is now rare. Here they may be amazed blood vessels, heart, nervous system.
Patients with syphilis are contagious in the first two stages of the disease. Adequate treatment gives positive result with primary, secondary and latent syphilis. Immunity is not developed during treatment. Self-medication, which is extremely widespread nowadays, is often accompanied by incomplete cure, which leads to recurrence of the disease and the appearance of new patients.
Gonorrhea – an infectious disease caused by gonococcus. In men, it appears 2–7 days after infection. Patients experience pain in the urethra when urinating, followed by the appearance of pus in the urine and an increased urge to urinate. In women, the first signs of the disease are detected later (7–21 days after infection) and appear much milder than in men. In addition to the urethra, gonorrheal inflammation can develop in the rectum, mouth and eyes.
Trichomoniasis – an infectious disease caused by a single-celled microorganism Trichomonas vaginalis. Despite the fact that the genitourinary tract of this disease is infected in both men and women, manifestations are observed only in women. With trichomoniasis, yellow-green, foamy contents are released from the vagina. The vulva and surrounding skin are inflamed. Urination is painful. In men, the disease is practically asymptomatic, but they can infect their sexual partners.
Genital herpes - infectious disease caused by a virus herpes simplex. Symptoms of a primary infection appear 4–7 days after infection: itching, tingling, soreness, the formation of a red spot, on the surface of which there is a group of small blisters that open and form an ulcer, then covered with crusts. Ulcers, like urination, are painful, walking is difficult. The patient's health deteriorates and the body temperature rises. The first outbreak of the disease always takes longer and is more painful than subsequent ones. Usually, inflammatory process localized on the genitals. In patients with weakened immune system function, the process spreads to other areas of the body.
Almost all diseases belonging to this group are characterized by a sharp rejuvenation in the age of patients. For tuberculosis requiring long-term hospitalization and sanatorium treatment, a child staying outside the home often learns worse and does not have the necessary social adaptation. Often patients with tuberculosis become disabled in childhood. Availability psychological problems can interfere with normal relationships with peers, creating a family and obtaining a profession.
Psychological and social problems are formed in HIV-infected and AIDS patients. Society is not ready for mutually acceptable coexistence with this category of patients; the normative standards adopted in this area legal acts are not always fulfilled. These reasons cause “social rejection” of such patients from others. Feeling like outcasts, they are capable of suicide.
Sexually transmitted diseases often occur with various complications, which are the direct causes of infertility. Thus, in 80% of young men, infertility is caused by chlamydia and its complications.
Tuberculosis, HIV infection, sexually transmitted diseases negatively affect demographic situation in the Russian Federation due to a decrease in the birth rate and an increase in mortality at a younger age.
Most diseases in this group require long-term, sometimes lifelong, expensive treatment, which creates an additional financial burden on the patients themselves and their families. On a national scale, such costs are quite high. They include funds spent on preventive actions, early diagnosis and its improvement, creation of new treatment methods and medicines, professional, psychological and social rehabilitation sick.
Mental disorders and behavioral disorders.
A disease caused by the human immunodeficiency virus (HIV).
Diabetes.
Malignant neoplasms.
Tuberculosis.
Hepatitis.
Infections that are predominantly sexually transmitted.
Diseases caused by high blood pressure.
The concept of “socially significant diseases”.
An elementary analysis of the phrase “socially significant” shows that diseases of this group have great importance for society, pose a threat to a large number of people. The concept of socially significant diseases includes a number of diseases that pose the greatest threat to the well-being of the country's population. The main features included in the concept of a socially significant disease are:
· the widespread nature of the disease, that is, a high percentage of the spread of the disease among the population, including the presence of a significant percentage of “hidden” patients in society,
· high rates of annual growth in the number of patients; diseases of this group tend to spread quite quickly,
· restriction of the patient’s full functioning in society in the presence of such a disease,
· danger of disease for others,
· infectious and non-infectious nature.
In addition, diseases belonging to this category not only destroy the health and body of a person, but also carry with them negative social consequences: loss of family, friends, job, livelihood, etc. Characteristic Such diseases lie in the fact that they claim the bulk of the lives of young people and people of working age. Important feature socially significant diseases is that if you know how not to get sick and follow certain rules, then the disease can be prevented or stopped by early stage diseases.
The situation with the spread of diseases of this group has become so acute that it is causing concern at the level of the government of the Russian Federation. Epidemiological observations served as the basis for compiling list of socially significant diseases. In accordance with Article No. 41 of the Fundamentals of Legislation of the Russian Federation on the protection of the health of citizens, the Government of the Russian Federation approved a list of diseases classified as socially significant. (Resolution No. 715 of December 1, 2004 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others”). This list includes: disease caused by the human immunodeficiency virus (HIV), tuberculosis, hepatitis, sexually transmitted infections, diabetes mellitus, malignant neoplasms, mental and behavioral disorders, diseases characterized by high blood pressure.
Order of the Ministry of Health and Social Development dated October 7, 2011 No. 1154n approved the distribution of subsidies provided in 2011 from the federal budget to the budgets of constituent entities of the Russian Federation for co-financing of activities regional programs, implemented at the expense of the budget of a constituent entity of the Russian Federation, within the framework of the federal target program “Prevention and Combating Socially Significant Diseases (2007-2012)”, in order to financially support expenses for improving the provision of specialized medical care:
For diabetes mellitus;
For diseases of tuberculosis;
In cases of sexually transmitted infections;
In cases of mental disorders;
For diseases of arterial hypertension;
In case of HIV infection;
For diseases viral hepatitis.
The inclusion of a certain nosology in the list of socially significant diseases depends on a number of national, cultural and economic factors. For example, in Japan, diabetes is a common, but not socially significant disease. Medicine provision and education of patients is organized in such a way that they average duration life is no lower than that of a person who does not have diabetes. Tuberculosis – serious problem for Russia, many countries in Africa and Asia, and in countries North America the prevalence of the disease is low.
The current share of complications in diabetes mellitus is 35%. 1% of patients underwent limb amputation. In total, for the first time during the year, people with disabilities due to diabetes mellitus 38.6 thousand people were recognized.
Morbidity vascular disorders brain (cerebrovascular diseases, including stroke) due to arterial hypertension is 5776 cases per 100,000 thousand population, mortality is 325 cases per 100 thousand population.
The number of newly registered cases of HIV infection reached 37.7 thousand, in correctional institutions Federal service execution of punishments – 2 thousand cases. The proportion of HIV-infected pregnant women included in the program for the prevention of HIV infections in newborns was 75%.
The incidence of acute viral hepatitis B and C reached 8.6 and 4.5 cases per 100 thousand population, respectively, chronic viral hepatitis B and C - 51.4 cases per 100 thousand population.
Socially significant diseases Moreover, diseases that pose a danger to others affect public interests. Here there is a possible conflict between private interests, the implementation of the will of individuals (to be treated or not) and the interests of society. Finally, state interests are interests whose bearer is the state. The representatives of these interests are the competent state and other authorized bodies.
Today, the incidence rate is so high that, in the opinion of many epidemiologists, sociologists, hygienists, etc., in order to reduce the social significance of diseases of this group, in addition to all of the above, it is necessary to ensure:
· full functioning of an individual in society in the presence of a disease.
· reducing the number of “hidden” patients and guaranteeing the absence of a significant number of similar patients in society (due to improving the quality of diagnosis in the first years, the number of officially registered patients will certainly increase, however, in the end, the social significance of the disease will be reduced due to a decrease in the number of fatal and seriously traumatic outcomes of treatment of the disease, due to the start of treatment at an early stage, for example, cancer patients).
So, socially significant diseases are a group of diseases that pose a threat modern society. Today, the situation with the spread of socially significant diseases is very serious, requiring the consolidation of many structures, not only government, medical, pedagogical, but also volunteer ones. Volunteering has great potential in an organization primary prevention, the essence of which is to expand hygienic knowledge among young people, the formation of health-saving behavior strategies in situations associated with the risk of infection or the onset of the development of a disease.
Let's look at some of the most common and dangerous diseases from the above list, included in the 1st and 2nd groups.
2. Mental disorders and behavioral disorders.Mental disorders pose a serious threat to the social well-being of people. More than 450 million people worldwide suffer from mental or neurological disorders. About a quarter of the population, both in developed and in developing countries suffer from certain mental disorders different periods life.
There are currently 120 million people in the world with depression and 37 million with Alzheimer's disease. About 50 million suffer from epilepsy and 24 million from schizophrenia. However, according to WHO, 41 percent of states do not have a developed policy regarding mental illness, 25 percent of countries do not have legislation on this issue. Two-thirds of governments allocate no more than one percent of their health budget to psychiatry.
Today, the World Health Organization notes a growing trend in the number of mental illnesses in society. Some experts associate this phenomenon with the unstable socio-economic situation in the country. According to official data, in Russia today there are 6 million people with mental problems. According to medical statistics, since the 90s, Russia has been one of the five countries with the highest number of suicides. The current epidemiological situation has determined that mental disorders are included in the list of the most significant social diseases. The highest level of primary incidence of mental disorders, especially borderline pathology, is observed in adolescence. This is due to the fact that at this age each individual experiences the action of two natural, but ambiguous processes: intensive socialization of the individual and active physiological restructuring of the body. So, in particular, a serious problem adolescence is insufficient social adaptation, manifested primarily in a high frequency of behavioral violations - from increased conflict and lack of discipline to behavior, the obligatory and determining component of which is the commission of illegal actions.
To prevent the epidemiological situation from worsening, society needs to understand its seriousness. To do this, people must have reliable information about these diseases.
Depression(lat. deprimo “to crush”, “to suppress”) is a mental disorder, an illness that is characterized by a decrease in mood, loss of the ability to experience joy, and impaired performance.
Symptoms of depression are very extensive and vary depending on the severity of the disease. It's safe to say that depression is a disease of the whole body. The most common symptom of depression is low mood. Very often, a person suffering from this illness experiences sadness, a feeling of hopelessness, worry and fear, guilt and anxiety. He becomes irritable, withdraws into himself, minimizes or does not communicate at all with friends and family. A person stops enjoying previously enjoyable activities. His self-esteem decreases, he loses interest in life, in hobbies, in his favorite hobbies. Life becomes as if colorless and flat. From the physiological side of manifestation depressive state - feeling of constant fatigue. A person quickly gets tired even after doing things that he previously handled with ease. Often he experiences constant fatigue, i.e. as if you had not rested at all, and short-term rest does not give the desired effect, sexual desire decreases. Physical disorders such as headaches, problems with digestion and heart function, and other pain may also appear. A person prone to depression very often suffers from sleep disturbances. He cannot fall asleep for a long time in the evening or, on the contrary, he finally wakes up too early in the morning. Appetite decreases or, on the contrary, overeating occurs.
Neuroses- the most common type of painful conditions caused by exposure to traumatic factors; they are characterized obsessive states, hysterical manifestations, etc., a critical attitude towards them, preservation of the consciousness of the disease, the presence of somatic and autonomic disorders.
Neurosis(or whatever it is called neurotic disorder) - This common name groups of certain functional psychogenic reversible disorders. Neurosis has a direct tendency towards a protracted course. Today, neurosis is characterized by a decrease in mental and physical performance. Most often it manifests itself in the form of hysteria or variants of obsessive behavior and is an asthenic state of a person. Neurosis is directly related to the condition nervous system, and if a person has experienced any strong experiences, stress, or had some other impact on the nervous system, then the likelihood of nervousness increases. As practice shows, neurosis most often occurs due to severe stressful situations. It is stress that causes exhaustion of the nervous system, resulting in impaired heartbeat, as well as the work of the stomach and other organs.
The main causes of neuroses:
· Severe physical or mental stress, expressed in constant work, without the possibility of rest for a long time. The emergence of a permanent, i.e. chronic stress, as well as strong emotional distress associated with problems in his personal life. The combination of these factors gives a double effect in the development of neurosis.
· Severe exhaustion of the nervous system due to the inability to perform a certain task or solve a problem.
· Busy work schedule, without the opportunity to rest, or inability to rest.
· Innate tendency to get tired quickly, and then overwork.
· Abuse of alcohol or drugs.
· The presence of diseases accompanying nervousness that greatly deplete the body, and in particular the immune system.
Main symptoms of neurosis. Symptoms of neurosis are divided into mental and somatic. TO mental symptoms include:
· Emotional stress, often manifested in the form of arising without visible reasons obsessive thoughts and obsessive actions.
· Acute reaction and unpreparedness for stressful situations. If some people react to this with tearfulness or aggression, then with neurosis a person becomes fixated and withdrawn. Constant worries and anxiety for no apparent reason. Possible development of phobias.
· Fast fatiguability, chronic fatigue.
· High sensitivity To sudden changes temperature, as well as bright light and very loud sound.
· The appearance of complexes about one’s communication, low or too high self-esteem.
· Changeable mood depending on trifles. Severe irritability.
GOVERNMENT OF THE RUSSIAN FEDERATION
RESOLUTION
On approval of the list of socially significant diseases and the list
diseases that pose a danger to others
Document with changes made:
Decree of the Government of the Russian Federation dated July 13, 2012 N 710 ( Russian newspaper, N 165, 07/20/2012).
____________________________________________________________________
Government of the Russian Federation
(Preamble as amended, put into effect on July 28, 2012 by Resolution of the Government of the Russian Federation dated July 13, 2012 N 710.
decides:
Approve the attached:
List of socially significant diseases;
List of diseases that pose a danger to others.
Chairman of the Government
Russian Federation
M. Fradkov
List of socially significant diseases
APPROVED
Government resolution
Russian Federation
dated December 1, 2004 N 715
Name of diseases |
|
________________ * (10th revision). |
|
1. A 15-A 19 | tuberculosis |
2. A 50-A 64 |
|
3. At 16; At 18.0; At 18.1 | Hepatitis B |
4. B 17.1; At 18.2 | hepatitis C |
5. V 20-V 24 | disease caused by a virus |
6. From 00-С 97 | malignant neoplasms |
7. E 10-E 14 | diabetes |
8. F 00-F 99 | mental disorders and disorders |
9.I 10-I 13.9 | diseases characterized by increased |
List of diseases that pose a danger to others
APPROVED
Government resolution
Russian Federation
dated December 1, 2004 N 715
Name of diseases |
|
________________ *International Statistical Classification of Diseases and Related Health Problems (10th revision). |
|
1. V 20-V 24 | disease caused by a virus |
2. A 90-A 99 | viral fevers transmitted |
3. B 65-B 83 | helminthiasis |
4. At 16; At 18.0; At 18.1 | Hepatitis B |
5. B 17.1; At 18.2 | hepatitis C |
diphtheria |
|
7. A 50-A 64 | infections transmitted predominantly |
9. B 50-B 54 | malaria |
10. B 85-B 89 | pediculosis, acariasis and other infestations |
glanders and melioidosis |
|
anthrax |
|
13. A 15-A 19 | tuberculosis |
cholera |
|
Revision of the document taking into account
changes and additions prepared
JSC "Kodeks"
Educational materials
Current issues prevention of socially significant diseases
Prepared by:
Storozhuk V. T.
2017
Dear listeners!
You are presented with educational materials for self-study“Current issues in the prevention of socially significant diseases” After studying educational materials on this topic you must:
must know:
· a list of socially significant diseases and diseases that pose a danger to others, risk groups;
· tuberculosis: epidemiology, factors contributing to transmission of infection, classification, diagnosis, signs of the disease, prevention, role nursing staff in prevention of this disease;
· sexually transmitted infections: classification, causes contributing to high incidence, complications, prevention, role of secondary medical workers in the prevention of STIs;
· mental behavioral disorders, types of drug addiction, substance abuse, alcoholism, diagnostics, stages of alcoholism.
Socially significant diseases and diseases that pose a danger to others. 4
Appendix No. 1. 10
Appendix No. 2. 11
Tuberculosis ICD – 10 – A15-19. 12
Sexually transmitted infections ICD A50 - A64. 29
Mental disorders and behavioral disorders (ICD F 00 – F99) 43
Socially significant diseases and diseases that pose a danger to others
The existence of the categories “socially significant diseases” and “diseases posing a danger to others” should begin with the adoption in 1993 of the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens (hereinafter referred to as the Fundamentals). Art. was devoted to socially significant diseases. 41, and for diseases that pose a danger to others - Art. 42 Basics Until this time, concepts such as " social diseases", "socially significant diseases" were found in specialized literature.
New legislation
At the end of 2011, the Basics were replaced by the federal law“On the fundamentals of protecting the health of citizens in the Russian Federation” (hereinafter referred to as the Law on the Fundamentals). Yes, Art. 43 of the law is called “Medical assistance to citizens suffering from socially significant diseases and citizens suffering from diseases that pose a danger to others.” The combination of two categories in the title of one article indicates a convergence of the concepts of “socially significant” and “posing a danger to others”, the formation of a unified (or similar) legal regime for the provision of medical care, and the provision of similar or identical legal status.
Let us pay attention to other provisions of the new law, which mention the provision of medical care to citizens suffering from socially significant diseases and diseases that pose a danger to others.
The new law does not contain clear definitions of the concepts of socially significant diseases and diseases that pose a danger to others. The absence of legal definitions in the text of a special law is possible and acceptable if the terms are well-established, they are used by the professional community and they do not cause any difficulties for the law enforcer. The only practical guideline for doctors and law enforcement officers is the current Decree of the Government of the Russian Federation dated December 1, 2004 No. 715 “On approval of the list of socially significant diseases and the list of diseases that pose a danger to others,” since new law also refers to lists. However, the question of the criteria for forming the lists remains open, which makes it possible to arbitrarily change the composition of nosologies in it.
Socially significant diseases
Socially significant diseases are diseases whose occurrence and (or) spread largely depends on socio-economic conditions. For example, outbreaks of tuberculosis are facilitated by crowded population, unfavorable living conditions, unhealthy and poor nutrition, etc. The lack of minimum required hygiene knowledge and properly developed skills can lead to outbreaks of hepatitis A, sexually transmitted infections, and others (Appendix No. 1 “List of socially significant diseases”).
The main feature and at the same time the key problem of socially significant diseases is the ability to spread widely (mass). In patients suffering from diseases of this group, the need for medical care increases as their condition worsens and complications arise. Treatment of such patients requires attracting additional funds and strengthening the material and technical base of health care institutions.
In the absence of adequate government measures (organizational, technical, financial, medical-prophylactic, therapeutic, etc.), the level of morbidity, disability and mortality from certain diseases increases, the life expectancy of the population decreases, huge amounts of money are spent on stabilizing the morbidity situation and eliminating negative social and macroeconomic consequences. It is no coincidence that in Part 2 of Art. 43 of the Law on Fundamentals states that the list of socially significant diseases and the list of diseases that pose a danger to others is approved by the Government of the Russian Federation based on high level primary disability and mortality of the population, reduction in life expectancy of the sick.
At the same time, socially significant diseases in a number of ways can hardly be compared with diseases that pose a danger to others.
