Organization of monitoring of tuberculosis infection foci in the megalopolis
Authors: Bogorodskaya E. M. , Belilovsky E. M. , Bezuglaya S. Yu. , Oganezova G. S. , Shamuratova L. F. 
Published: November 2024

Introduction . Identification of a tuberculosis patient, detection of all foci formed by him and anti-epidemic work in each focus are one of the most important areas of preventive work of anti-tuberculosis institutions. In the metropolitan metropolis, special attention paid to improving this work, including by creating a system for monitoring foci of tuberculosis infection.

Materials and methods . The information and program implementation of the task of monitoring foci of tuberculosis infection within the framework of the development of the urban system of epidemiological monitoring of tuberculosis is considered. The data of the register of the tuberculosis infection foci monitoring system (TbFM), introduced in 2021 and including information on all 4487 foci, which were worked with during 2021, and information about which was available in the database on 01.01.2022, was analyzed.

Results. The forms for the TbFM developed by a significant modification of the current account card of the examination of the hearth. The software basis of the TbFM is the Medical Database Management System (MDMS) «Barclay-SV» – a flexible software shell developed by GBUZ «MNPC TB control DZM» together with LLC «Elecard-Med». The MDMS ensures the connection of data about the patient who created the focus with information about him in the registers of detection, dispensary observation and control of treatment operating in the tuberculosis monitoring system of the city of Moscow.

A cohort of 1,798 foci registered in 2021 and 1,488 foci registered in previous years, but not closed by January 1, 2021, analyzed. Among the 1,798 foci registered in 2021, 63.6% formed by tuberculosis patients permanently residing in the city, 23.3% – residents of other subjects of the Russian Federation, 11.1% – foreign citizens and 2.0% – homeless persons. 47.2 ± 1.7 (95%CI 43.8–50.6) contact persons per focus were examined in the foci under consideration.

Among 1798 foci registered in 2021, 24 foci of group morbidity registered, where 35 patients were identified in addition to the index patient, 26 of them were detected during the initial examination of the focus, one was in the IV GDN, 5 were detected not simultaneously and not from the IV GDN, and 3 tuberculosis patients arrived at the focus.

The incidence of tuberculosis among contacts from the immediate environment (before the focus became known to the tuberculosis service) was 371 (95% CI 252-526) per 100 thousand close contacts. Under observation, 2 people fell ill in the IV GDN in 2021, according to one of the foci registered in 2020 and 2021, which corresponds to the incidence in the IV GDN equal to 12 (95% CI 1-43) per 100 thousand contacts from the immediate environment.

Conclusions. The city of Moscow has implemented a system for monitoring foci of tuberculosis infection, which, with a compact volume of data recorded and entered into the register, allows analyzing this area of work in a wide range. The monitoring results once again confirmed the particular complexity of the organization of phthisiological care to the population of the metropolis due to the significant migration burden, and showed a significant amount of work carried out in the city with foci of tuberculosis infection and its effectiveness.