ЭПИДЕМИЧЕСКАЯ СИТУАЦИЯ ПО ТУБЕРКУЛЕЗУ В РОССИИ

Abstract

The objective: to describe the current state of tuberculosis situation before the start of the national healthcare project which is to be implemented till 2024. Materials. The data from Federal Statistics Forms no. 8, 33, and 61. The number of those died is presented as per the data of Rosstat. Epidemiological rates were calculated as per mi d-y ear population. Results. In Russia, tuberculosis situation has stabilized and there is a tendency for its improvement, and the changes in main tuberculosis rates provide the evidence of the above. For 10 years (from 2008 to 2017) the following main tuberculosis rates went down: tuberculosis incidence – from 85.1 to 48.3 per 100,000 pop. (by 43.2%); tuberculosis incidence among children from 0 to 14 years old – from 15.3 to 9.7 per 100,000 pop. (by 36.6%); tuberculosis prevalence by the end of the year – from 190.7 to 109.8 per 100,000 pop. (by 42.4%); bacillary excretion in tuberculosis patients – from 80.3 to 46.0 per 100,000 pop. (by 42.7%); tuberculosis mortality – from 17.9 to 6.5 per 100,000 pop. (by 63.7%). In 2017, tuberculosis incidence among resident population, HIV negative (33.4), was lower than the minimum rate, which was registered in Russia in 1991, when HIV infection provided no significant impact on tuberculosis situation in the country (34.0 per 100.000 pop.). in 2017, tuberculosis mortality (6.5 per 100,000 pop.) which hardly now includes those HIV infected and died of tuberculosis, is lower than the minimum rate documented in 1989 (7.4 per 100,000). In the long view, the developing HIV epidemics will provide a negative impact on tuberculosis situation given the growing rates of the patients at the advanced stages of HIV infection and the increasing number of patients with multiple drug resistance. HIV infection will not allow achieving a significant reduction of tuberculosis incidence and will result in the growing fatality among tuberculosis patients in the number of the regions of the Russian Federation. Currently, it is not necessary to concentrate on the number of those examined but to improve the quality of screening in the groups facing a high risk to develop tuberculosis and to consider r e-o rganization of tuberculosis services due to the reduction of tuberculosis incidence. During 10 years (201 8-2 027), tuberculosis incidence is to be reduced twice. The program for tuberculosis incidence reduction is to be predicted for each region specifically, considering the current tuberculosis situation and the level of tuberculosis detection organization. In parallel, the effective tuberculosis care is to be provided for those HIV infected.