Evaluation of the efficiency of preventive examinations of the adult population, aimed at early tuberculosis diagnosis

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Abstract

BACKGROUND: In Russia, compared with other countries, at least 65% of the population must undergo an annual fluorographic examination for early tuberculosis detection.

AIM: This study aimed to assess the impact of mass fluorographic examinations of the adult population on the main epidemiological factors and indicators of prompt tuberculosis detection.

MATERIALS AND METHODS: The morbidity and mortality from tuberculosis have been analyzed along with the efficiency of its detection during preventive examinations, the proportion of destructive forms of the disease, and the 1-year mortality rate in four federal districts from 2014 to 2019.

RESULTS: For all districts, low efficiency of preventive examinations was registered (1 patient per 2,000–5,000 people examined), as well as its strong correlation with morbidity and, in case of its absence, with the coverage of examinations. The change in morbidity and mortality rates over time was independent of the mass screening volume of the adult population. The relative risk indicators of increased morbidity and mortality with a decreased number of examinations were 0.4 and 0.3, respectively. The increased coverage of the population with examinations was not accompanied by an improved indicator of detection timeliness, namely a decreased incidence of destructive forms and 1-year mortality rate. The incidence of tuberculosis is determined by socioeconomic factors, which influence the level and living conditions of the population.

CONCLUSIONS: This study established the low efficiency of mass fluorographic examinations of the population, lack of influence of coverage with examinations on the epidemiological situation, and the timeliness of tuberculosis detection.

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About the authors

Lyudmila V. Rubis

Petrozavodsk State University

Author for correspondence.
Email: rublusja@mail.ru
ORCID iD: 0000-0001-6602-9621

MD, Cand. Sci. (Med.)

Russian Federation, Petrozavodsk

Yuriy M. Markelov

Petrozavodsk State University

Email: markelovi@karelia.ru
ORCID iD: 0000-0003-0791-0050

MD, Dr. Sci. (Med.), Professor

Russian Federation, Petrozavodsk

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Supplementary files

Supplementary Files
Action
1. Fig. 1. Incidence of tuberculosis, first detected in four federal districts of Russia in 2009–2019 (per 100 thousand): the ordinate axis — years, the abscissa axis — the rate per 100 thousand population, FEFD — Far Eastern Federal District, SFD — Siberian Federal District, NWFD — Northwestern Federal District, CFD — Central Federal District.

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2. Fig. 2. The efficiency of detecting tuberculosis in the course of fluorographic examinations of the adult population and one-year mortality rate of newly diagnosed patients in the Russian Federation in 2009–2019: ordinate axis — years, abscissa axis 1 — frequency of tuberculosis detection during preventive examinations per 1,000 patients examined; abscissa axis 2 — one-year mortality rate (%).

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3. Fig. 3. The mortality rate of tuberculosis patients in four federal districts of Russia in 2009–2019 (per 100 thousand population): ordinate axis — years, abscissa axis — indicator per 100 thousand population, FEFD — Far Eastern Federal District, SFD — Siberian Federal District, CFD — Central Federal District, NWFD — Northwestern Federal District.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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