Epidemiological Situation Of Tuberculosis Research Articles

Tuberculosis in Poland in 2021.

To evaluate the main features of epidemiology of tuberculosis (TB) in 2021 in Poland and to compare with the situation in the European Union and European Economic Area (EU/EEA) countries. Analysis of case-based data on TB patients from National TB Register, data on anti-TB drug susceptibility in cases notified in 2021, data from Statistics Poland on deaths from tuberculosis in 2020, data from National Institute of Public Health NIH - National Research Institute (NIPH NIH - NRI) on HIV-positive subjects for whom TB was an AIDS-defining disease, data from the report "European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2022 - 2021 data. Copenhagen: WHO Regional Office for Europe and Stockholm: European Centre for Disease Prevention and Control; 2022." In 2021, 3704 TB cases were reported in Poland. The incidence rate was 9.7 cases per 100,000 with large variability between voivodeships from 5.4 to 12.6 per 100,000. A decrease in the incidence with respect to 2020 was found in 8 voivodeships, the most significant in lubuskie voivodship (42.6%). The number of all pulmonary tuberculosis cases was 3,553 i.e. 9.3 per 100,000. Pulmonary cases represented 95.9% of all TB cases. In 2021, 151 extrapulmonary TB cases were notified (4.1% of all TB cases). Pulmonary tuberculosis was bacteriologically confirmed in 2,970 cases (83.6% of all pulmonary TB cases, the incidence rate 7.8 per 100,000). The number of smear-positive pulmonary TB cases was 2,085 i.e. 5.5 per 100,000 (58.7% of all pulmonary TB cases). In 2021, there were 54 cases (25 of foreign origin) with multidrug resistant TB (MDR-TB) representing 1.9% of cases with known drug sensitivity. The incidence rates of tuberculosis were growing along with the age group from 0.6 per 100,000 among children (0-14 years) to 15.8 per 100,000 among subjects in the age group 45-64 years, the incidence rate in the age group ≥65 years was 11.7 per 100,000. There were 37 cases in children up to 14 years of age (1.0% of the total) and 51 cases in adolescents between 15 and 19 years of age - rates 0.6 and 2.8 per 100,000 respectively. In 2021, there were 2,690 cases of tuberculosis in men and 1,014 in women. The TB incidence in men - 14.6 per 100,000 was almost 3.0 times higher than among women - 5.1. The biggest difference in the TB incidence between the two sex groups occurred in persons aged 55-59 years, 30.5 vs. 6.6 and in age group 60 to 64 years, 26.0 vs. 5.7. In 2021, there were 132 patients of foreign origin among all cases of tuberculosis in Poland (3.6%). In 2020, TB was the cause of death for 474 people (mortality rate - 1.2 per 100,000). The incidence of tuberculosis in Poland in 2021 was 10.2% higher than in 2020. The percentage of tuberculosis cases with bacteriological confirmation was 82.6%, higher than the average in EU/EEA countries (72.0%). The percentage of MDR-TB cases was lower than the average in EU/EEA countries (1.9% vs. 3.8%). The highest incidence rates are found in Poland in the older age groups (in EU/EEA countries in people aged 25 to 44). The percentage of children up to 14 years of age among the total number of TB patients was 1.0%, the average in the EU/EEA countries was 3.5%. The incidence of tuberculosis in men was nearly three times higher than in women in Poland. The impact of migration on the epidemiological situation of tuberculosis in Poland in 2021 was smaller than in the EU/EEA countries (in Poland, the percentage of foreigners among all TB patients was 3.6 vs. 33.8% in the EU/EEA).

The epidemiological situation of tuberculosis in Spain according to surveillance and hospitalization data, 2012-2020.

Before the COVID-19 pandemic, tuberculosis (TB) was the leading cause of death from a single infectious agent. In Spain, TB notifications are registered through the National Epidemiological Surveillance Network (RENAVE). The Minimum Basic Data Set (CMBD) provides information on TB hospital discharges. This study aims to assess both registries to complete the picture of TB in order to improve national control strategies and make further progress toward its elimination. A retrospective study was performed considering CMBD´s hospital discharges with TB as first diagnosis and notifications to RENAVE between 2012 and 2020. After describing the records of both systems and their differences by using descriptive and multivariate analysis, annual incidences rates were calculated in order to evaluate temporal trends and geographical patters. According to the CMBD database, there were 29,942 hospitalizations due to TB (65% pulmonary forms and 66% male) during the study period. RENAVE collected 44,520 reported cases, mostly males (62%) with pulmonary forms (72%). Young children were similar in both groups, showing the high frequency of hospitalization in this group. Almost all autonomous communities showed a downward trend, especially Asturias. Hospitalizations in 2020 were analyzed by month separately, and comparing with previous years, the impact of the COVID-19 pandemic can be seen. A decreasing trend on TB incidence was observed in Spain since 2012, although this trend might change after COVID-19 pandemic. The analysis of both databases, CMBD and RENAVE, has contributed to improve our knowledge of TB in Spain and will help improve the control of this disease.

The Impact of the War in Ukraine on the Epidemiological Situation of Tuberculosis in Europe.

Ukraine is at the forefront of one of the largest outbreaks of tuberculosis (TB) in Europe, including multidrug-resistant tuberculosis. Due to the ongoing armed conflict in this area, there is a significant number of refugees from Ukraine to other European countries. The aim of the study is to emphasize the essence of the problem of the increased incidence of tuberculosis, taking into account the impact of the armed conflict in Ukraine, resulting in the intensification of migration movements. A descriptive epidemiological method was used as the research method. The material was collected by analyzing source statistical data from WHO and statistical yearbooks of selected European countries. Particularly, Ukrainian refugees in Poland, Germany, the Czech Republic, and Slovakia are at higher risk of contracting tuberculosis due to factors like migration stress, poor nutrition, and comorbidities. Epidemiological data from these countries show a rise in tuberculosis cases among foreigners, emphasizing the need for European specialists to be more vigilant in this unique situation, focusing on refugees and other vulnerable populations. More research and collaborative efforts are essential to closely monitor and prevent the severe outcomes of tuberculosis transmission.

Epidemiological situation of tuberculosis in children and adolescents in the Kyrgyz Republic

Epidemiological situation of tuberculosis in children and adolescents in the Kyrgyz Republic

Comparative characteristics of the epidemiological situation of chemoresistant tuberculosis in Germany and Ukraine

Objective — to compare the epidemiological situation of chemoresistant tuberculosis in Germany and Ukraine, in addition analyzing the nature and features of chemoresistant tuberculosis in 192 patients treated at the Ternopil Regional TB Dispensary Ukraine during 2017—2018.
 Materials and methods. In order to study the comparative characteristics of the epidemiological situation with chemoresistant tuberculosis in Germany and Ukraine, modern literature sources were used with the search query «epidemiological situation with chemoresistant tuberculosis in Germany», «epidemiological situation with chemoresistant tuberculosis in Ukraine». Separatelly a retrospective cohort study was conducted. The nature and features of the course of chemoresistant tuberculosis in 192 patients who were treated in the Ternopil Regional TB Dispensary during 2017—2018 were analyzed. 
 Results and discussion. Analysis of literature sources showed that multidrug resistant Tuberculosis (MDR-TB) is relatively seldom in Germany with around 100 cases annually. Overall, the epidemiological situation of MDR-TB has been stable since the beginning of the statistical recording of the disease in 2002. In 2013, the highest proportion of MDR TB was registered at 3.3 %. Detailed analysis of notifi cation data shows that the tuberculosis situation in Germany is mainly influenced by migratory movements and demographic changes in the population. Despite the positive overall epidemiological trend with decreasing incidence rates, however, the burden of TB in Ukraine remains significant. According to the latest WHO estimates for 2018, TB incidence in the country(new cases and relapses) is the 4th highest among 53 countries of the WHO European Region.To address the situation, reduce TB prevalence, scale up TB early detection and diagnosis, and ensure effective treatment, Ukraine adopted, in 2019, the 2020–2023 State Strategy for Development of Anti-Tuberculosis Care for the Population.The analysis performed of 192 patients of the MDR/XDR-TB Cohort from the TB-Dispensary Hospital in Ternopil (Ukraine) from 2017—2018, showed that the resistanse of mycobacteria to anti-TB drugs was dominated by cases of MDR-TB — 57.3 %. Among patients first diagnosed were 52.6 %, relapses were 46.4 %. Destruction in the lungs was detected in 71.9 %. 111 patients (57.8 %) had treatment success, and 81 (42.2 %) had poor treatment outcomes or were lost to follow-up.
 Conclusions. The epidemiological situation of tuberculosis in Germany is stable and improving. Despite the positive overall epidemiological trend, the burden of TB in Ukraine remains significant. In 2018, TB incidence in the country (new cases and relapses) was 80 per 100 thousands population. In Ukraine during the period (2015—2018), the proportion of «pre-XDR» and XDR cases increased from 47.4 to 51.3 %. Among patients with chemoresistant tuberculosis, MR TB predominates (57.3 %), with destruction in the lungs and only 57.8% are effectively treated.

Epidemiological trends in tuberculosis in Ukraine at the beginning of the COVID­-19 pandemic

Objective — to examine the tendencies of the epidemiological situation on tuberculosis in Ukraine at the beginning of the COVID-19 pandemic in 2020. 
 Materials and methods. The analysis of the data of official statistics in 2015—2020, a survey of 157 medical experts and a telephone questionnaire survey of 69 residents of the Volyn region.
 Results and discussion. It was established that the disease of COVID-19 has found its imprint on the epidemiological situation of tuberculosis and on the functioning of the TB care service. In 2020, the rate of decline in the incidence of pulmonary and extrapulmonary tuberculosis was significantly more intensive than in previous years. However, the incidence of tuberculosis among contacts with bacterial excretion in tuberculosis foci increased 1.85 times in each year. The frequency of tuberculosis recurrences is steadily decreasing.The prevalence and mortality from all forms of active tuberculosis among the entire population of Ukraine has a tendency similar to a decrease in morbidity.The effectiveness of treatment of patients of all categories is proportional to the severity of the tuberculosis process, but still insufficient. Mortality in TB care institutions increased in the previous year against the decrease of this indicator in previous years. Against the background of the inaccessibility of the population to TB care, day hospitals are underused, and the sanatorium network needs to be reorganized. The surgical method of treatment of patients is extremely insufficiently realized.
 Conclusions. The dispensary contingent of TB care institutions is decreasing every year. There is a reduction in the infrastructure of the TB care service, and in each year, the largest reduction was in the bed stock of TB care institutions and sanatoriums, as well as a decrease in the number of TB doctors.

Complex Analysis of the Epidemiological Situation of Tuberculosis used as an Additional Tool for Determining the «Risk Areas»on the Siberian Federal District

Relevance. The article presents an example of using the method of integral assessment of the epidemiological situation of tuberculosis, which is applied to the main statistical criteria as a more accurate approach in assessing the manifestation of the epidemic process and identifying «risk areas» within the Siberian Federal District. The essence of the method consists in ranking the statistical indicators used from the minimum values to the maximum values for the entire study period, and further summing the ranks for each indicator. The resulting integral indicator is further used to calculate the generalized visibility coefficient.Aim. Argumentation of «risk areas» associated with tuberculosis infection in the Siberian Federal District using a comprehensive assessment of the main epidemiological indicators.Results and discussion. A complex assessment of the epidemiological situation of tuberculosis infection on the territory of the Siberian Federal District made it possible to identify regions with an unfavorable epidemiological situation (Novosibirsk and Kemerovo regions, Altai Territory, Irkutsk region and the Republic of Tyva), which require a comprehensive study to determine the causal relationships and risk factors lying in based on the observed deterioration in key epidemiological indicators.Conclusion. In terms of risk-based surveillance, regions with an unfavorable epidemiological situation can be designated as «territory zones».

ВОЗМОЖНЫЕ ПРИЧИНЫ ФОРМИРОВАНИЯ РЕЦИДИВОВ ТУБЕРКУЛЕЗА У ДЕТЕЙ В СОВРЕМЕННЫХ УСЛОВИЯХ: КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ

The epidemiological situation of tuberculosis (TB) has been improving steadily in recent years however, in the structure of TB patients, there is a high proportion of patients with multidrugresistant/extensively drug-resistant (XDR) pathogens and people with HIV and TB co-infection. As a result, cases of TB disease in children with many risk factors for unfavorable outcome of therapy are recorded, leading to subsequent relapse. the aim of the work was to analyze possible causes of formation and structure of clinical forms of recurrence of TB in children. A retrospective analysis of outpatient cards and medical records of children of residents of the Leningrad region, who had a TB relapse, was carried out. It has been established that in Leningrad Oblast, there were 3 cases of recidivism of TB among children registered from 2011 to 2020. The main risk factor for the development of primary TB was the lack of immunization against TB due to perinatal contact with an HIV-infected mother. The provoking factors of TB relapse were the occurrence of exogenous superinfection of TB, the presence of HIV infection in the child, the presence of large residual changes after primary TB, close contact with a TB patient with an XDR of the causative agent.

ОЦЕНКА ЭПИДЕМИОЛОГИЧЕСКОЙ ОБСТАНОВКИ ПО ТУБЕРКУЛЕЗУ НА УРОВНЕ СУБЪЕКТА

Significance. The current epidemiological situation of tuberculosis in Russia has a negative trend. It is influenced not only by medical, but also by demographic, socio-economic, environmental and other factors. Purpose. Identify the most important socio-economic and environmental factors of organization and effectiveness of anti-tuberculosis measures, which influence the main epidemiological indicators of tuberculosis. Material and methods. The study was conducted by processing and analyzing materials of the state statistical reporting of the Ministry of Health of the Russian Federation for the period 2016-2018. The method of Pearson correlation analysis with matrix construction was used. Calculations were performed using Statistica 6.0 package. Significance of differences was determined by Student's criterion. Differences were considered statistically significant at p ˂ 0.05. Results. The epidemiological situation of tuberculosis in the Trans-Baikal Territory has a positive trend. Quality indicators of detection, diagnosis and treatment of tuberculosis in the region are characterized by improvements. The study has identified: a strong direct correlation between the share of areas not equipped with water supply and sewage and such indicators as: incidence of tuberculosis among adults, tuberculosis prevalence, and feedback on coverage of children aged 1-14 with immunodiagnostics; a direct correlation between the share of housing without central heating and prevalence of tuberculosis; an inverse correlation between the number of sports facilities and the level of tuberculosis incidence and tuberculosis prevalence among adults; and a strong direct correlation between air pollution emissions and incidence of tuberculosis among adolescents. Conclusion. The correlations identified confirm that tuberculosis is socially and economically determined, making it possible to identify risk factors for deteriorating epidemiological indicators of tuberculosis and substantiating a system of measures aimed at improving organization of TB care delivery to the population of the Trans-Baikal territory.

Análise temporal e epidemiológica dos casos de tuberculose no Estado do Piauí, Brasil

A tuberculose é uma doença crônica infecciosa e transmissível. Ela é adquirida por meio da inalação do Mycobacterium tuberculosis que está presente no ar, quando um indivíduo infectado, ao tossir, espirrar ou até mesmo falar, expele partículas contaminadas por esse agente. Acomete principalmente os pulmões, porém, pode atingir os rins, ossos e meninges. Assim, o presente estudo teve como objetivo analisar o perfil epidemiológico da tuberculose no estado Piauí no período de 2014 a 2018. As variáveis analisadas foram: faixa etária, sexo, raça, casos confirmados por ano de diagnóstico, número de casos notificados nos municípios, tipo de entrada, taxa de incidência, forma clínica da tuberculose, situação de encerramento e comorbidades associadas. A análise foi realizada mediante os dados disponibilizados pelo SINAN/DATASUS. Foram obtidos os seguintes resultados, 2018 foi o ano com maior número de notificações (843), o sexo mais atingido foi o masculino em todos os anos analisados, a forma clínica mais comum foi a pulmonar, as comorbidades mais prevalentes foram alcoolismo, tabagismo e diabetes, o tipo de entrada mais comum foi caso novo; na situação de entrada o maior percentual foi o de cura, no entanto, ignorado/branco obteve um número maior no ano de 2018. Além disso, a faixa etária mais acometida foi de 40 a 50 anos, seguida de 20 a 39 anos; as cidades com maior número de casos foram Teresina e Parnaíba, no entanto, as de maior incidência foram, Bom Princípio, Parnaíba e Cocal de Telha; a maior taxa de incidência ocorreu no ano de 2018, e por fim, a raça parda obteve o maior número de casos.

Avaliação de tuberculose em crianças e adolescentes no Pará

Objetivo: O trabalho propõe-se estudar a situação epidemiológica de casos novos da tuberculose entre a faixa etária de 0 a 19 anos no Estado do Pará, Brasil, no período de 2008 a 2018. Métodos: Trata-se de um estudo observacional descritivo, retrospectivo, de base de dados secundários, utilizando-se o Banco de dados do Sistema de Informações de Agravos de Notificação (SINAN). Avaliando as seguintes variáveis: idades, sexo, forma clínica da doença, forma diagnóstica e desfecho dos casos. Resultados: O número absoluto de pacientes triados foi de 4452 pacientes. Verificou-se o coeficiente de incidência acima da média 5,6% durante o período. Houve predomínio do sexo masculino. A forma clínica pulmonar ocorreu em 84,35% dos casos. A maioria dos casos (69,9%) evoluíram para a cura. Conclusão: Os resultados apresentados contribuem para o conhecimento da situação epidemiológica da tuberculose, fornecendo subsídios à tomada de decisões relacionadas principalmente às ações de prevenção e controle da doença no Estado do Pará.

Evolution, Trends, and Potential Explanations of the Increase in the Incidence of Tuberculosis: the Case of Uruguay

A descriptive analysis of the trend of tuberculosis incidence in Uruguay between 1995 and 2018. In 2015, World Health Organization (WHO) proposed The END TB Strategy; the Latin American countries that implemented these strategies at the first level of care have had successful outcomes in terms of the reduction in the incidence, morbidity, and mortality of the disease. Uruguay is a striking case in the regional environment regarding tuberculosis epidemiology. The trend of tuberculosis had a turning point in 2006, which defines two clearly different periods. The first period covers the year 1995 to 2006 and shows a significant decrease in the incidence rate and the second period covers the year 2006 to 2018 and shows a significant increase in the incidence rate. The proportion of contacts of tuberculosis cases receiving prophylactic treatment, the percentage of cases lost to follow-up, and the magnitude of the bacillary burden at diagnosis moment are possible factors linked to the changes in the trend of the incidence of tuberculosis. The initiation of a gradual transfer of the responsibilities of the National Program of Tuberculosis in diagnosis, treatment, and prevention to primary care health providers in the National Integrated Health System will hopefully contribute to reverse the epidemiological situation of tuberculosis in the country.

And Epidemiological Characteristics of Tuberculosis in Children in the Astrakhan Region

The article presents the results of the analysis of the epidemiological situation of tuberculosis in children of the Astrakhan region for the period from 2013 to 2017. The incidence of tuberculosis of children in the region exceeds the average Russian Federation 2.9, the southern Federal district in 3.2 time. In the structure of morbidity of children is dominated by tuberculosis of intrathoracic lymph nodes (75.6%). The increase of tuberculosis morbidity of children population of the region could also be: the increasing incidence and delayed diagnosis of tuberculosis in adults introduction in practice of modern methods of diagnostics (computer tomography, PCR, Diaskintest) allowing to identify the disease in a larger number of patients, lack of alertness of doctors of general medical network on early diagnosis of tuberculosis.

HIV INFECTION AMONG PATIENTS WITH TUBERCULOSIS IN MOSCOW

The study is devoted to the evaluation of the impact of the spread of HIV infection on the epidemiological indicators of tuberculosis in a megacity. Based on information from the registers of the tuberculosis monitoring system in Moscow for 2014-2015. A comparative analysis of indicators for patients with tuberculosis was conducted with the presence and absence of co-infected HIV infection. The results showed that among patients with tuberculosis combined with HIV infection, patients from the city’s permanent population, from the age group of 31-40 years old, non-working, injecting drug users are much more likely than other TB patients. The number of tuberculosis patients who died of HIV infection, in comparison with the number of patients who died from tuberculosis, accounted for more than a third of the total number of tuberculosis-related deaths. Thus, when assessing the epidemiological situation of tuberculosis, it is necessary to take into account the significant contribution of HIV infection to the values of the main indicators and their dynamics.

Эпидемическая ситуация по коинфекции вич-туберкулёз в уголовно-исполнительной системе российской Федерации

The results of monitoring the epidemic situation of tuberculosis+ HIV, the results of diagnosis and outcomes of treatment in prisons of the Russian Federation as of 2017 are presented. The epidemiological situation of tuberculosis in the prisons of the Russian Federation is the most favorable for the last years. The mortality rate from tuberculosis decreased to 9.7 per 100 000. The reasons of this are: prisoners, as a rule, are representatives of marginalized groups of society, characterized by an antisocial way of life, promiscuity, drug use, and low sanitary culture. The reasons of stabilization of epidemic situation on tuberculosis in a combination with a HIV-infection are considered.

Dynamics of Main Indicators of the Epidemiological Situation on Tuberculosis in the Omsk Region

The aim of the study is to analyze the dynamics of the main epidemiological indicators that characterize the epidemiological situation of tuberculosis in the Omsk Region from 2001 to 2015. Material and methods. For the analysis were used for reporting forms: № 8 («Information on active tuberculosis», № 33 («Information on tuberculosis patients»), № 61 («Information on contingents of patients with HIV infection»). The statistical processing was carried out with the help of the Microsoft Excel software package, applied the method of analyzing the dynamic series with the calculation of the rates of growth/decrease in epidemiological indicators and the determination of the average geometric index for aligned series, regression analysis. Results. It has been established that in 2009 in the Omsk Region, the main indicators that characterize the epidemiological situation of tuberculosis have decreased: morbidity (by 25.4%), prevalence (by 55.5%), mortality (by 53.1%). At the same time, there was an increase in the incidence of multidrug-resistant disease, an increase in the incidence of HIV infection and HIV-associated tuberculosis. Conclusions. The obtained results allow to assume the possibility of developing a new period of worsening of the epidemiological situation of tuberculosis, characterized by high mortality and a further growth of the reservoir of infection in the region.

Епідеміологічна ситуація щодо туберкульозу у дітей підліткового віку в Україні

Епідеміологічна ситуація щодо туберкульозу у дітей підліткового віку в Україні

What Factors May Influence Epidemiological Situation of Tuberculosis in Poland and in the World?

The authors present the review of factors influencing epidemiological situation of tuberculosis in Poland and in the world. The groups of increased risk of tuberculosis, and clinical conditions predisposing to activation of latent tuberculosis infection (LTBI) such as HIV, uremia, diabetes mellitus, transplantation of organs, treatment with glucocorticosteroids and with antibodies to TNF and to its receptors, were presented. The higher prevalence and worse prognosis of tuberculosis in elderly people was emphasised. The methods of LTBI recognition, according to recent recommendations, with special consideration to patients in immunosupression, were shown. Methods of treatment to prevent LTBI activation, according to WHO experts, were also presented. All data were discussed in relation to the actual epidemiological situation of tuberculosis in Poland.

Risk factors affecting the epidemiological situation of tuberculosis, clinical and epidemiological features of pulmonary tuberculosis in rural areas

The formation of the level of health affects different areas of factors: social, geographic, environmental, etc. Despite the progress made in the fight against tuberculosis, in the late 80-ies of the XX century, it went out of control on a global scale. The downward trend in the spread of tuberculosis in the developed countries, observed during more than a hundred years, at the end of XX century has changed.

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