Comprehensive approach to the tuberculosis indicators assessment of the children population in the Republic of Crimea

Introduction. Childhood tuberculosis (TB) control is relevant due to the peculiarities of its course in this age group, and the TB incidence in children is an important prognostic epidemiological indicator.

Aim. Use of multivariate statistical analysis to estimate and predict childhood TB indicators in the Republic of Crimea (RC).

Materials and methods. The official TB statistics in the Republic of Crimea for 2014-2018 are used. The calculated means of the indicators are checked for normality using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Pearson correlation analysis is applied to determine pair correlation relationships. Stepwise multiple regression analysis is carried out to determine group conditionality of the indicators, where coefficients, with which significant pairwise correlations are found, are selected as independent variables. Based on the results, multiple regression equations are made to predict the values of dependent variables. The data is processed using Statistica 10.0 software.

Results. For childhood TB incidence, strong direct correlations are established with the incidence and prevalence of pulmonary TB among children. The paired correlation coefficient between the incidence of childhood TB and childhood lung TB and the detection of active TB patients in preventive examinations of children varied in the range of 0.63-0.72. For the prevalence of TB among children, strong direct correlations were found with the incidence of TB and pulmonary TB in children. Multiple correlation coefficients for the incidence and prevalence of childhood TB exceeded the values of paired correlation coefficients and were in the range of 0.93 to 0.98 (p<0.001), indicating greater significance of group conditionality of the indicators. Determination coefficients R² were between 0.87 and 0.96. Multiple regression models were built for the childhood TB incidence, childhood lung TB incidence, childhood TB prevalence, childhood lung TB prevalence.

Conclusion. The found strong direct pairwise correlations for childhood TB incidence and prevalence and childhood pulmonary TB incidence and prevalence can serve as prognostic criteria and reflect the quality of antituberculosis interventions. High values of paired correlation coefficient between childhood TB incidence and childhood pulmonary TB and detection of patients with active TB in preventive examinations of children are a criterion of quality of both TB services and primary care, which can prevent the spread of TB and improve the epidemic situation of TB in Crimea. The calculated multiple regression models for the studied indicators can serve the needs of practical forecasting in Healthcare.

1. Kopylova I.F., Smerdin S.V., Vertyachih M.G. Respiratory Tuberculosis in Children and Adolescents: Textbook. Kemerovo: KemSMA; 2007 (in Russian).

2. Dolgikh V.V., Khantaeva N.S., Yaroslavtseva Yu.N., Kulesh D.V. Epidemiological situation on tuberculosis among the children and teenage population 159 (review of literature). Acta Biomedica Scientifica 2013; (2(1)):159–164 (in Russian).

3. Aksenova V.A., Sterlikov S.A., Belilovskiy E.M., Kazykina T.N., Rusakova L.I. Epidemiology of tuberculosis in children. Sovremennye problemy zdravookhraneniya i meditsinskoy statistiki = Current Problems of Health Care and Medical Statistics 2019; (1):8−43 (in Russian).

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

5. Nechaeva O.B., Son I.M., Gordina A.V. Indicative support TB care to the population of the Russian Federation. Moscow: RIO CNIIOIZ MZ RF; 2014 (in Russian).

6. Son I.M., Rybka L.N., Skachkova E.I., Sterlikov S.A., Leonov S.A., Gordina A.V., Sel'covskiy P.P., Kucheryavaya D.A., Ponomarenko E.N., Kochkarev D.E., Zajchenko N.M., Sazykina I.G.. Evaluation of the tuberculosis epidemic situation and analysis of TB facilities. Moscow: CNIIOIZ; 2009 (in Russian).

7. The method of analysis of the epidemiological situation of tuberculosis: guidelines (approved by the Federal Service for Supervision of Consumer Rights Protection and Human Well-being from June 11, 2007 №0100 / 5973-07-34). Available at: https://docs.cntd.ru/document/902048275 (in Russian).

8. Golubova T.N., Makhkamova Z.R., Tkachenko I.Yu. Territorial differentiation of the tuberculosis morbidity and mortality trend in the Republic of Crimea. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2017; (66):22−28 (in Russian). https://doi.org/10.12737/article_5a1f7019efb6c1.83634772

9. Mahkamova Z.R., Ovsyannikova N.M., Golubova T.N., Tkachenko I.Yu. Forecast of the pulmonary tuberculosis incidence number in the Republic of Crimea. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Seriya: Meditsina. Farmatsiya = Belgorod State University Scientific Bulletin (Medicine, Pharmacy) 2017; 19(39):127−138 (in Russian).

10. Golubova T.N., Mahkamova Z.R., Ovsyannikova N.M., Tkachenko I.Yu. Current territorial differentiation of the tuberculosis epidemiology and tuberculosis control service indicators in the Republic of Crimea. Tavricheskiy Mediko Biologicheskiy Vestnik 2017; 20(4):44−49 (in Russian).

11. Mikhailova Yu.V., Soshnikov S.S., Shikina I.B., Biragova O.K. Analyzing impact of TB control measures on TB epidemiological indicators. Social Aspects of Population Health 2014; (6). Available at: http://vestnik.mednet.ru/content/view/639/30/lang,en (in Russian).

12. Mihajlovskij A.M., Chepasov V.I. The correlation and factorial analysis of the epidemic situation on the tuberculosis in the Orenburg region. Vestnik of the Orenburg State University 2013; (1):126−131 (in Russian).

13. Smetanina E.A., Luk'janenko N.V., Lysov A.V.,. Smetanin A.G, Leonov S.L. Possibility of statistical methods for prognosing the mortality rates from tuberculosis and tuberculosis morbidity. Sibirskoe meditsinskoe obozrenie = Siberian Medical Review 2012; (3):87−91 (in Russian).

14. Khantaeva N.S., Mikhalevich I.M., Kulesh D.V. Analysis and prediction of epidemiological indices of tuberculosis on the basis of multidimensional methods. Byulleten' Vostochno-Sibirskogo nauchnogo tsentra SO RAMN (Acta Biomedica Scientifica) 2011; (2):184−189 (in Russian).

15. Ayvazyan S.A., Mhitaryan V.S. Applied Statistics and Fundamentals of Econometrics. Moscow: YUNITI; 1998 (in Russian). ISBN 5-238-00013-8

16. Halafyan A.A. Modern Statistical Methods of Medical Research. 3rd edition. Moscow: Lenand; 2014 (in Russian). ISBN 978-5-9710-1009-8