Modern Features of the Epidemiological Situation of Tuberculosis in Ukraine (Review)

Abstract

Objective — to study the epidemiological situation of tuberculosis in Ukraine from 2018 to 2022. Materials and methods. This research utilised a comprehensive source base including official statistical data from the State Statistics Service and the Ministry of Health of Ukraine, scholarly articles from both international and domestic researchers, materials from periodicals and international conferences and internet resources. Additionally, the insights and analyses were enriched by involving six experts and organisers from the phthisiatric service. These experts were instrumental in interpreting statistical data and identifying causal relationships within the dynamics of the epidemiological indicators. Results and discussion. From 2018 to 2022, the incidence of tuberculosis (TB), including its recur­rences, in Ukraine decreased by 27.3 %. During this timeframe, TB incidence among children aged 0—14 years fell by 16.9 %, and among adolescents aged 15—17 years, it dropped significantly by 45.8 %. Despite these overall reductions, a notable increase in TB incidence was observed across the Ukrainian population by approximately 3.5 % and specifically among children aged 0—14 years by 25.4 % in 2021, compared to 2020. The Odesa Oblast reported the highest morbidity rate across all Ukrainian regions over this five-year period, although it experienced a 36.0 % reduction from 2018 to 2022. Importantly, the prevalence of all forms of active TB across the Ukrainian population decreased by 40.7 % from 2018 to 2022. This decline was also reflected among children aged 0—14 and 15—17 years, with decreases of 34.1 and 49.7 %, respectively. Statistically, the highest morbidity rate among healthcare institution employees in Ukraine was observed in 2018, reaching 6.0 per 10,000 employees. Conclusions. Since 2020, a concerning trend has emerged in Ukraine with an increase in the incidence of tuberculosis by almost 3.5 %, and a sharp rise of 25.4 % among children aged 0—14 years in 2021, reversing the previously declining trend. This uptick is likely influenced by the COVID-19 pandemic. Despite this, there was a notable decrease in the prevalence of all forms of active TB across Ukraine's entire population by 40.7 % from 2018 to 2022. The highest morbidity rate among healthcare workers was observed in 2018, at 6.0 per 10,000 workers. A significant concern remains TB's impact on the working-age population, leading to permanent disability. However, the rate of primary disability due to TB among the adult and working-age population showed a decrease in 2022 by 11.4 and 3.9 %, respectively. The underdiagnosis of TB, potentially exacerbated by the COVID-19 pandemic and the ongoing conflict, poses a significant challenge to controlling the disease.