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Summary. Epidemiological situation concerning
tuberculosis is affected by disadvantaged groups, HIV infection and
spread of drug-resistant strains of Mycobacterium tuberculosis.
Objective: to study impact of social factors, HIV infection and drug resistance on tuberculosis morbidity.
Methods: key trends in tuberculosis epidemic have been analyzed based
on the statistical data reporting and personalized automated
epidemiological monitoring in the Republic of Bashkortostan.
Results: Dynamics of the epidemiological situation concerning
tuberculosis in the Republic of Bashkortostan was characterized by
reduced TB morbidity incidence from 114.0 to 26.7 in 1970-1990, with a
rise up to 70.1 in 2000 and subsequent decline to 47.0 per 100 000
population in 2010. Prevalence of tuberculosis was 601.0, 151.9, 181.9,
119.8 per 100 000 population respectively. In 1991-2010 a number of the
able-bodied unemployed among newly diagnosed TB patients increased from
3.6% to 46.0%.
In 1999-2011 504 patients with HIV-TB co-infection were detected.
During those years the share of HIV-positive patients among newly
diagnosed TB patients increased from 0.1% to 5.6%, and up to 10.8% in
the city of Ufa. 71.4% of the able-bodied patients with HIV-TB
co-infection were unemployed. The age structure of newly diagnosed TB
patients was the following: under 18 years - 0.2%, 18-30 years – 45.0%,
31-40 years – 42.7%, over 40 years – 12.1%. 208 patients with active
tuberculosis (41.3%) died, and 62 patients (12.3%) were completely
cured.
Prevalence of drug-resistant TB and multidrug-resistant TB in 6829
sputum smear-positive patients, including 2528 newly diagnosed patients
has been analyzed for the period of 2007-2011. Multi-drug resistance
among newly diagnosed patients increased from 12.6% to 21.9%, and
drug-resistant tuberculosis increased up to 5.2%. Multidrug resistance
in sputum smear positive patients increased from 34.6% to 54.9%, and
drug-resistance increased to 21.6%.
Conclusions. The country has developed a tendency towards decreased
tuberculosis morbidity over the last decade. However, epidemiological
situation concerning tuberculosis is influenced by a sharp increase in
TB incidence among the able-bodied unemployed and HIV-positive people
and spread of the multi-drug resistant causative agent, which requires
that TB control activities be organized with due regard to those
factors.
Keywords. Tuberculosis; HIV infection; morbidity; multi-drug resistant tuberculosis; risk group.
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