Trends of the tuberculosis epidemical situation during and after the COVID-19 pandemic: Russia and the northwestern federal district, 2020–2023

Abstract

The dynamics of TB incidence and mortality is an important tool for assessing epidemiological well-being. Monitoring of a number of key indicators has shown that the COVID-19 pandemic has made serious adjustments to the current style and methods of operation of the TB care system. There is a point of view that this is a natural result of restrictive measures taken to combat the pandemic — an airborne disease, including a decrease in the active detection of tuberculosis cases. Therefore, it seemed relevant to us to study the dynamics of the main indicators characterizing both the epidemic situation with tuberculosis in Russia and the effectiveness of the measures taken to detect tuberculosis from 2010 to 2023, as well as to assess the possibility of achieving the targets of the End TB strategy. Methods. The dynamics of the number of TB incident cases and the number of HIV-negative TB deaths in 2010–2023 relative to the number of these cases were analyzed according to the results of regression analysis, based on 2010–2019 data. Results. It was noted that the COVID-19 pandemic did not lead to a significant increase in the number of deaths from tuberculosis, but contributed to an increase in the number of cases of postmortem detection and early (before 1 year of observation) TB deaths of new tuberculosis cases. During the pandemic, there was a decrease in the number of incident cases of tuberculosis, an increase in the proportion of new TB cases with destructive, including fibro-cavernous tuberculosis. The impact of migration processes associated with the special military operation on the incidence of tuberculosis was small. Conclusion. The technique, which involves the use of regression analysis, makes it possible to clarify details of processes associated with the epidemiology of tuberculosis with greater accuracy. The COVID-19 pandemic did not have a significant impact on the dynamics of the number of deaths from tuberculosis, but it did affect the detection rates of tuberculosis patients. In general, in Russia and the Northwestern Federal District, the goals of the End TB strategy, which envisage a decrease in the number of TB incidents, are expected to be achieved. Achieving the indicator stipulating a decrease in the number of deaths from tuberculosis is more likely in the Northwestern Federal District, and less likely in Russia as a whole.

Keywords: tuberculosis, consequences of the COVID-19 pandemic, TB incidence, TB mortality, geographical features