DOI: 10.21045/2071-5021-2016-50-4-8
N.A. Zubova
Republic TB Dispensary, Saransk, Republic of Mordovia
Contacts: Natalia A. Zubova,
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Background. Decline in tuberculosis morbidity rates results in lower effectiveness of detection based on screening.
Purpose: to assess effectiveness of mass preventive
examinations in the Republic of Mordovia, where morbidity rates of
tuberculosis (TB) are low.
Materials and methods: indicators were calculated on the basis
of the Rosstat (Federal State Statistics Service) reporting forms #8,
#33 and #30. Rosstat data on population of Russia and Mordovia were used
for calculations. For comparative analysis Fisher accurate method for
comparison of 2x2 tables in EPI INFO software, Version 3 (EPO CDC, 1988)
was applied.
Results: in Mordovia, in 2000-2015, TB morbidity rates
decreased by 1.6 times, equaling to 37.3 per 100,000 population. The
total decline rate of for the same time period was 39.1%. The share of
population covered by mass preventive examinations for the same period
of time increased 1.1 times adding up to 83.5% in 2015. By contrast, the
share of TB patients identified through examinations, dropped by 1.2
times reaching up to 0.034% in 2015. Results of the comparative analysis
showed that in Mordovia it is not advisable to increase share of the
eligible population for screening over 70%, since this method allows to
detect a small part of new tuberculosis cases only and has no effect on
frequency of registration of smear positive patients.
Moreover, screening in Mordovia is economically inefficient because
of the multifold increase in implementation costs: in ten out of the 18
districts with low TB morbidity rates ranging from 28 to 37 per 100,000
population, it takes to examine from 2455 to 13178 healthy individuals
to detect a TB patient. In 18 districts of the Republic of Mordovia (78%
of the total) with TB morbidity rates below 40 per 100,000 population,
chest x-rays should be carried out primarily in direct contacts of
patients with microbiologically proven TB.
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Keywords: tuberculosis, morbidity, screening, chest x-rays.
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