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Main arrow Archive of previous Issues arrow 4 2016 (50) arrow EFFECTIVENESS OF MASS PREVENTIVE EXAMINATIONS IN SUBJECTS OF THE RUSSIAN FEDERATION WITH LOW MORBIDITY RATES OF TUBERCULOSIS
EFFECTIVENESS OF MASS PREVENTIVE EXAMINATIONS IN SUBJECTS OF THE RUSSIAN FEDERATION WITH LOW MORBIDITY RATES OF TUBERCULOSIS Print
Tuesday, 26 July 2016

DOI: 10.21045/2071-5021-2016-50-4-8

N.A. Zubova
Republic TB Dispensary, Saransk, Republic of Mordovia

Contacts: Natalia A. Zubova, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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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