Prospects for the elimination of tuberculosis in the Northwestern Federal District of Russia

Abstract

The most prosperous TB situation in Russia is observed in the Central and Northwestern Federal Districts, where there are the greatest chances to be the first in the Russian Federation to achieve the target indicators of the End TB strategy. Since 2018, a set of measures has been implemented under the slogan: «NWFD — a territory free from tuberculosis». The purpose of this study is to study the dynamics of morbidity and mortality from TB in the Northwestern Federal District and the Russian Federation in 2005–2021. The study of morbidity — according to the forms No. 8 and No. 33 of the FSN, mortality — according to demographic data. Mortality from TB in the NWFD over 15 years decreased by 7.6 times from 19.6 in 2005 to 2.6 per 100,000 in 2020 (in the Russian Federation by 4.8 times from 22.6 to 4.7), on average by 12.5% per year (in the Russian Federation by 9.9%). In recent years, the decline in the indicator began to slow down exponentially. If the trend continues, mortality in the NWFD, compared with 2015, may decrease by 83% by 2025 and by 97% by 2035, which corresponds to the End TB target criterion. There is a linear trend towards a decrease in the incidence by 3.2 times from 63.2 per 100,000 in 2009 to 19.7 in 2021 (2.7 times in the Russian Federation from 82.6 to 31.1). On average, over 12 years, the indicator in the NWFD decreased linearly by 9.2% per year (in the Russian Federation by 7.7%) to zero by 2026, which is practically unrealistic. In the coming years, we should expect a slowdown in the rate of decline in incidence with a transition to an exponential trend. In 2020, there was an acceleration in the decline in the incidence of TB, and in 2021, a worsening of the clinical structure of TB cases due to the COVID-19 epidemic. In recent years, the NWFD has seen a more favorable trend in reducing the incidence of MDR- TB and TB/HIV than the average for the Russian Federa- tion. There is a pronounced trend towards a decrease in the incidence of extrapulmonary tuberculosis, especially genitourinary localization.