THE IMPACT OF TERRITORIAL AND SOCIAL OBJECTS ON THE SPREAD OF TUBERCULOSIS INFECTION IN A METROPOLIS
Authors:   Mechnikov North-West State Medical University, St. Petersburg, Russia, Bozhkov Igor ,   Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia,   Saint Petersburg Postgraduate Institute of Medical experts, Saint Petersburg, Russia,   Independent non-profit educational organization of additional professional education “Center of programs and projects in the healthcare system”, St. Petersburg, Russia, Korneva Natalya ,   Mechnikov North-West State Medical University, St. Petersburg, Russia,   Saint Petersburg Postgraduate Institute of Medical experts, Saint Petersburg, Russia,   TB Dispensary No. 5, St. Petersburg, Russia, Chistobaev Anatolii ,   Saint Petersburg State University, St. Petersburg, Russia, Bozhkov Nikolai ,   Independent non-profit educational organization of additional professional education “Center of programs and projects in the healthcare system”, St. Petersburg, Russia,   Immanuel Kant Baltic Federal University, Kaliningrad, Russia, Sterlikov Sergey ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: January 2024

Significance. One of the key areas of TB prevention is work with household contacts, including epidemic monitoring and territorial assessment. However, approaches to dividing and defining the borders of the studied territories, assessing the impact of territorial objects on the risk of developing tuberculosis are undeveloped. It is important for analyzing dynamic changes in the epidemiology of tuberculosis within a particular territory and drawing up a plan of preventive measures. The purpose of the study was to analyze the relationship and impact of territorial objects within the borders of microterritories of a metropolis on TB spread in population of these territories. Material and methods: In 2021-2022, a longitudinal (retrospective-prospective) continuous spatial-epidemiological study of the epidemic situation of tuberculosis and latent tuberculosis infection was conducted. Results: The most significant parameters in the spread of tuberculosis infection are building density (p<0.0001) and population density, territorial objects as shops, educational facilities, medical organizations, recreation areas. MDR-TB in patients does not have a significant effect on the spread. However, the incidence of tuberculosis and territorial facilities in the catchment area of a phthisiological unit affect the spread of latent tuberculosis infection in children. Conclusion: The hypothesis about the relationship and influence of territorial objects on the spread of tuberculosis infection among the population of microterritories was confirmed. Epidemiological assessment and monitoring of the supervised territories should be carried out using boundaries established according to the principles of the geographical field. Scope of application. The results obtained should be taken into account when assessing the epidemiological situation and determining the workload of the phthisiological service in megacities, which is directly related to financial planning and individualization of approaches to evaluate performance of the district service, optimize interdepartmental and intradepartmental interaction and develop principles of interaction with the general medical network and population of microterritories.