Comparative analysis of the epidemiological situation and the efficiency of the phthisiatric service in the Republic of Crimea and the Russian Federation

Introduction. The epidemiologic situation of tuberculosis (TB) in the Russian Federation (RF) challenges regional TB services to improve their performance.

Aim. To assess the epidemiological situation of TB and the work of the phthisiatric service in the Republic of Crimea (RC) and the RF between 2018 and 2022.

Materials and methods. The epidemiological situation and the work of the phthisiatric service were analyzed using data from the Crimean Republican Clinical Center of Phthisiology and Pulmonology, the FSBI "National Medical Research Center for Phthisiopulmonology and Infectious Diseases" of the Ministry of Health of the Russian Federation, and the Russian Research Institute of Health. Statistical processing included the analysis of dynamic series.

Results. In 2018-2022 among the whole population of the RC, as in the RF, there was a trend of decreasing TB incidence and prevalence with a higher level of the indicator in the region. In RC, the rate of decline in TB incidence in the general population was higher than in the 0-17 age group. The proportion of children aged 0-14 years sick with TB in the RC compared to the RF was on average higher, with a more pronounced growth trend. The coverage of preventive examinations of the population and the proportion of detected TB patients in the RC were on average lower than in the country (by 1.5 and 1.3 times, respectively). The rate of decrease of the indicator in the region exceeded the national one. The ratio of morbidity to mortality in general, both in the RF and in the RC, had a positive trend. The rate of decrease of the indicator in the region exceeded the national one. The ratio of morbidity to mortality in general, both in the RF and in the RC, had a positive trend. In general, the rate of TB recurrence was decreasing in the country and the region. On average, the level of TB relapses in the RC exceeded the national level, but the rate of decrease in the indicator in the region was 4 times higher than in the RF.

Conclusion. Between 2018 and 2022, the epidemiological situation of TB in the RC, along with certain positive trends, was characterized by a number of problems, which, in our opinion, were due to the difficulties of the primary link and the anti-tuberculosis service during the COVID-19 pandemic.

1. Afanasev E.I., Russkikh O.E. [Modern trends in the epidemiology of tuberculosis and HIV infection worldwide and in the Russian Federation]. Russkiy meditsinskiy zhurnal = Russian Medical Journal 2021; 29(3):24−26 (in Russian).

2. Mikhailova Iu.V., Nechaeva O.B., Shikina I.B., Mikhailov A.Iu. [Resources of the Russian medical units providing care for those with socially important infectious diseases]. Tuberkulez i bolezni legkikh = Tuberculosis and lung diseases 2019; 97(6):8−15 (in Russian). https://doi.org/10.21292/2075-1230-2019-97-6-8-14

3. Siuniakova D.A. [Features of the epidemiology of tuberculosis in the world and in Russia in the period 2015-2020. Analytical survey]. Social`nye aspekty` zdorov`ya naseleniya 2021; 67(3):11 (in Russian). https://doi.org/10.21045/2071-5021-2021-67-3-11

4. Tuberculosis. WHO. (Update 2023). Available at: https://www.who.int/ru/news-room/fact-sheets/detail/tuberculosis

5. Mikhailova Iu.V., Soshnikov S.S., Shikina I.B., Biragova O.K. [Analyzing impact of TB control measures on TB epidemiological indicators]. Social`ny`e aspekty` zdorov`ya naseleniya 2014; 6(40):19 (in Russian).

6. Geltser B.I., Shakhgeldian K.I., Krivilevich E.B., Medvedev V.I., Ermolitskaia M.Z. [Certain approaches to efficiency evaluation of the regional TB services]. Tuberkulez i bolezni legkikh = Tuberculosis and lung diseases 2017; 95(12):28– 34 (in Russian). https://doi.org/10.21292/2075-1230-2017-95-12-28-34

7. Makhkamova Z.R., Golubova T.N., Sanina G.N., Tkachenko I.Iu. [Epidemiology of tuberculosis in the Republic of Crimea: current insights]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin of Physiology and Pathology of Respiration 2017; 64: 37−42 (in Russian). https://doi.org/10.12737/article_59360729bf9a86.75280866

8. Global tuberculosis report. Available at: https://www.who.int/teams/global-tuberculosis-programme/tbreports/global-tuberculosis-report-2022

9. WHO/Europe and ECDC joint press release: Tuberculosis remains one of the deadliest infectious diseases worldwide, warns new report. Available at: https://www.who.int/europe/news/item/24-03-2022-who-europe-and-ecdc-joint-press-release-tuberculosis-remains-one-of-the-deadliest-infectious-diseases-worldwide-warns-new-report

10. Vasil'eva I.A., Sterlikov S.A., Testov V.V., Mihajlova Ju.V., Obuhova O.V., Ponomarjov S.B. [Industry and economic indicators of anti-tuberculosis work in 2021-2022]. Moscow: Natsional'nyy meditsinskiy issledovatel'skiy tsentr ftiziopul'monologii i infektsionnykh zabolevaniy; 2023 (in Russian).

11. Seltsovskaia P.P., Plieva S.L., Svistunova A.S. [Risk factors of the pulmonary tuberculosis early relapses]. Tuberkulez i social`no-znachimy`e zabolevaniya 2015; 3: 4−10 (in Russian).