Microbiological diagnosis of tuberculosis in Russia in 2020: achievements and challenges

Abstract

Monitoring the status of microbiological diagnostics of tuberculosis is of major national and international importance for achieving tuberculosis control objectives.

Objective. To study and characterize the current state, major trends and current trends in the development of microbiological diagnostics of TB in progress.

Materials and methods. The study covered health care organizations of the executive authorities in the field of health services of the subjects of the Russian Federation. The data of industrial and single time statistical observation, as well as answers to special enquiries were studied.

Results and discussion. Detection of TB patients by means of sputum microscopy is insufficient, amounting to 14.9% in new cases and 10.8% in recurrent ones. The increase in the share of pulmonary TB patients with a positive sputum microscopy up to 35.1% can be associated with a worsening of active detection due to a new coronavirus infection. The share of newly-detected
pulmonary TB patients with a positive culture for Mycobacterium tuberculosis has also increased to 52.8%, but this is below the target (54.0%) and will not reach the target by 2024 (60.0%). The decrease is seen at both preanalytical and analytical phases, mainly in selected regions. The coverage by rapid methods was 87.4%, including WHO-recommended was 58.0%, which is below the target (90%). The coverage by drug sensitivity testing (DST) was 97.1% (target 100%). The coverage by DST of patients with resistance to rifampicin and fluoroquinolones was 93.5%, the coverage by DST of patients with resistance to linezolid was 35.0%, to bedaquiline — 8.5%, to two drugs — 6.6%.

Conclusion. It is advisable to intensify the targeted supervision by specialists in microbiological diagnostics of TB with low target values, paying attention to participation in quality assessment programmes, ensuring the possibility of DST to bedaquiline and linezolid.