THE INCIDENCE OF RESPIRATORY TUBERCULOSIS IN THE KALUGA REGION IN THE PERIOD BEFORE AND DURING THE COVID-19 PANDEMIC
Authors:   Federal Research Institute for Health Organization and Informatics", Tsybikova Erzheny ,   of the Ministry of Health of Russia, Moscow, Russia, Lapshina Irina ,   Kaluga State University named after K.E. Tsiolkovsky, Kaluga, Russia, Kotlovsky Mikhail ,   Federal Research Institute for Health Organization and Informatics" of the Ministry of Health of Russia, Moscow, Russia
Published: December 2023

Significance. Over the past two years the Covid-19 pandemic has disrupted the ten-year stable rate of decline in morbidity and mortality from tuberculosis (TB) in the Kaluga Region. The study results showed that the decrease in the incidence of respiratory tuberculosis during the pandemic was due to the negative impact of restrictive measures introduced during the pandemic on the schedule of TB screening, causing its reduction rather than the improved epidemic situation. As a result, the number of patients with common forms of respiratory tuberculosis has increased, which could have been sources of tuberculosis infection among the population for a long time, contributing to a higher number of TB cases over the subsequent years. Resuming the schedule of TB screening after the pandemic will also contribute to a higher number of newly detected TB patients. Purpose: to analyze the incidence of respiratory tuberculosis in the Kaluga region in the period before and during the Covid-19 pandemic. Material and methods. The analysis used data of the Federal statistical observation forms No. 8 and No. 33 for 2010-2021. To assess the screening effectiveness and TB epidemic situation in Russia and the Kaluga region, the following indicators were calculated: coverage of adults with TB screening with fluorography (2015-2021), TB incidence (2010-2021) and TB mortality (2015-2021). The analysis of the respiratory TB incidence in the Kaluga region covered the period from 2015 to 2021, including the pre-pandemic period from 2015 to 2019 and the pandemic – 2020-2021. Statistical analysis was carried out using the StatTech program v.2.8.8 (developed by Stattech LLC, Russia). Pearson's Chi-squared test was used for data analysis. The differences were recognized as significant at p <0,05. Results. Over a decade (2010-2019) before the pandemic, the TB incidence in Russia and the Kaluga region was steadily decreasing. In 2015-2019, the adult coverage with TB screening in the region was high adding up to 64.8% on average. However, the effectiveness of screening was declining, since in order to detect the first patient with respiratory tuberculosis in 2019, it took to examine 3,438 healthy individuals, which was 1.8 times more than in 2015. During the pandemic (2020-2021) in Russia and the Kaluga Region, significant changes were registered in the respiratory TB incidence dynamics due to a rapid decrease in its values. The reason for this situation was the introduction of restrictive measures (lockdown), which lasted longer for older adults. The decreased coverage with TB screening in the Kaluga region aimed at early TB detection, and the reduced number of TB cases detected have resulted in the accelerated rates of reduction in the respiratory TB incidence. Conclusion. The study results showed that the decreased incidence of respiratory tuberculosis during the pandemic in the Kaluga region was due to the negative impact of the restrictive measures on the schedule of TB screening, causing its reduction, resulting in the decreased number of patients with respiratory tuberculosis detected rather than improvements in the epidemic situation.