Trends in tuberculosis epidemiology in the Republic of Crimea for the period 2014-2021

Aim. To assess the epidemiological situation on tuberculosis (TB) in the Republic of Crimea in 2014­2021 based on the study of morbidity, prevalence and mortality.Materials and methods. The analysis was conducted based on official data presented by the Crimean Republican Clinical Center of Phthisiology and Pulmonology.Results. During the study period in the Republic of Crimea the TB incidence decreased in 2.1 times. The downward tendency of both the incidence of all forms of TB (the growth rate is 51.7%) and pulmonary TB (growth rate is 50.2%) has been de­tected. The incidence of destructive forms of TB in Crimea reduced by 1.6 times, the proportion of destructive forms among first-time detected cases of TB was 48.2%. The peak of TB prevalence in the Republic of Crimea was in 2014 (132.1 cases per 100,000 population). In the following years there was a positive trend and by 2021 the rate decreased by 1.7 times, amounting to 77.8 cases per 100 thousand population. During the study period in the region there was a 2-fold decrease in the TB mortality rate from 17.1 in 2014 to 8.3 cases per 100 thousand population in 2021 (growth rate -51.5%). Despite the steady decrease in the mortality rate from all forms of TB in the region, there is still a stable high proportion of TB patients who died before the first year of follow-up. One of the reasons for the negative situation should be called the late diagnostics of the pathology under study, which is confirmed by the average percentage for the period 2014-2021 of untimely detected cases of TB, as well as neglected forms of TB (33.7% and 22.5%, respectively). During the period when the Republic of Crimea was a part of the Russian Federation, the financing of TB service increased by 2.1 times and, accordingly, the possibility of improving the quality and efficiency of medical care for TB patients increased, which is certainly one of the important reasons for the positive trends in improving the epidemiological situation of TB in the re­gion for the period 2014-2021.Conclusion. Over the period 2014-2021 in the Republic of Crimea, against the background of significant improvement in the financing of TB services in the region, positive dynamics in the main indicators of the epidemiological situation of TB (morbidity, prevalence and mortality) were observed. At the same time, the part of TB patients who died before the first year of follow-up remained high.