The effect of external and internal migration on the notification of tuberculosis in the metropolis

Field: Medicine (Health Sciences)

Introduction The purpose of this study was to assess the relationship between the value of tuberculosis notification rate in 2019-2022 with limiting measures associated with the COVID-19, a change in the legislative base of the stay of migrants in the country, and, as a result, a change in the channels of detecting the disease among certain groups of external and internal migrants. Materials and methods The study used data on 8771 of new tuberculosis (TB) cases from the Moscow city TB surveillance system for 2019-2021 and 9 months of 2022 without post-mortem TB detection. A comparison of groups of patients determined by the status of residence in the city: patients from the permanent population of the city, residents of other regions of the Russian Federation and residents of other states, which included only citizens of the Republic of Tajikistan, the Republic of Uzbekistan and the Kyrgyz Republic, because among former USSR countries, these countries currently have a decisive influence on the TB incidence rate in the city. A comparative assessment of changes in the monthly number of new TB cases, registered in these groups. Analyzed the socio-demographic composition of groups, data on the TB detection channels, as well as on the foci of tuberculosis infection in the city. According to the Ministry of Internal Affairs, data on changes in migration flows in Moscow and information obtained from the multifunctional migration center of Moscow (MMC) were made, including information on the flows of foreign citizens who applied to the MMC for a medical examination during the registration of a patent. Results In 2019 and 2020, a decrease in the mean of the monthly number of registration of new TB cases was noted: 41.2 ± 2.5 and 29.8 ± 2.6, respectively, among residents of other regions of the Russian Federation (p < 0.01), 20.6 ± 1.3 and 16, 1 ± 3.0 - the Republic of Tajikistan (p <0.01), 14.3 ± 1.1 and 12.7 ± 3.0 - the Republic of Uzbekistan (p = 0.139), and 17.3 ± 1.2 and 16,3 ± 2.3 - the Kyrgyz Republic (p > 0.05). In the 3rd quarter of 2021, a significant increase in the number of new TB cases among citizens of the republics of Tajikistan and Uzbekistan occurred. If in 2019, 2020 and in the first 9 months of 2021, on average, 20.9 ± 1.2, 16.0 ± 3.1 and 14.1 ± 3.2 cases of diseases of citizens of The Republic of Tajikistan were monthly registered, respectively, and 14.5 ± 1.0, 12.6 ± 3.0 and 10.1 ± 2.5 monthly registered new TB cases of citizens of the Republic of Uzbekistan, then in the last quarter of 2021 - 78.7 ± 7.3 and 60.0 ± 4.4 new TB cases were already monthly registered respectively from citizens of these two countries (p <0.01), respectively. For the first 9 months of 2022 the values of the mean monthly detection of the new TB cases among the citizens of the Republic of Uzbekistan and residents of other regions of the Russian Federation returned to the mean annual level of 2019-2020 - 13.7 ± 2.8 and 31.2 ± 4.2, respectively (p > 0.05 for both groups)/ New TB cases in citizens of the Republic of Tajikistan became significantly higher than the same indicator in 2020 and in the first 9 months of 2021 (p <0.01), and even slightly higher than in 2019 (p = 0.059). A significant increase in the number of new TB patients was registered since March 2022 among citizens of the Kyrgyz Republic - up to 27.6 ± 7.5 cases, which is two times higher than the previous values of this indicator (13.2 ± 1.5 - in 12 months 2021). Thus, from 2019 to October 2022, three significant changes in TB notification rate in Moscow were noted - a decrease in the indicator in 2020 compared to 2019, an increase in the indicator in 2021, starting from October and, finally, an increase the indicator in the first half of 2022, compared with 2021. These changes determined by the dynamics and channels of the detection of TB patients in Moscow among citizens of three countries - the Republic of Tajikistan, the Republic of Uzbekistan and the Kyrgyz Republic and amendments to regulatory documents governing migration flows in the Russian Federation. Conclusions New TB patients in citizens of the Republics of Tajikistan and Uzbekistan and the Kyrgyz Republic had a decisive influence on changes in the indicator of TB notification rate in Moscow in the period 2019-2022. The coverage of foreign citizens with a medical examination, being the most important tool for early detection of tuberculosis, it significantly affects the increase or decrease in the indicator of TB notification rate in the city.