Spatial patterns of tuberculosis in Russia in the context of social determinants

Our study investigated the spatial distribution of tuberculosis and the influence of social determinants in Russia between 2006 and 2018 using the regional incidence of multi-drug resistance tuberculosis, HIV-TB coinfection, and mortality data. The "space-time cube" method identified the uneven geographical distribution of the tuberculosis burden. There is a clear distinction between a healthier European Russia, where a statistically significant stable trend towards a decrease in incidence and mortality was found, and the eastern part of the country, where there is no such trend. Generalized linear logistic regression analysis found that the challenging situation was associated with HIV-TB coinfection incidence, with a high incidence rate being detected even in more prosperous regions of European Russia. HIV-TB coinfection incidence was determined by a set of socioeconomic variables, out of which the influence of income and urbanization were the most pronounced. The influence of crime could indicate the spread of tuberculosis in socially disadvantaged regions.