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Tuberculosis in Siberia: 1. An epidemiological and microbiological assessment
F Drobniewski1, E Tayler, N Ignatenko
1Regional Tuberculosis Centre, Dulwich Public Health Laboratory, London.
Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|June 1, 1996
Summary
Tuberculosis cases are rising in Siberia, with incidence rates significantly higher than the Russian Federation average. Factors like homelessness and alcoholism contribute, while prisons may be a key source of infection.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Tuberculosis (TB) trends in the Russian Federation showed a reversal from a downward to an upward trajectory around 1990/91.
- Siberia exhibits notably higher TB incidence and prevalence rates compared to the national average.
Purpose of the Study:
- To evaluate the current tuberculosis situation in Siberia as a representative model for the Russian Federation.
- To identify contributing factors and assess the healthcare system's response to TB in the region.
Main Methods:
- Data collection involved official sources and site visits to TB dispensaries and hospitals in Siberia during 1994.
- Surveillance utilized regular fluorography and tuberculin testing, with case classification based on clinical and radiological findings.
- Information on Bacille Calmette-Guérin (BCG) immunization schedules and drug resistance patterns was also gathered.
Main Results:
- TB incidence in Siberia ranged from approximately 43 to 108 per 100,000 population, with prevalence at 250-300 per 100,000.
- Fluorography detected half of all diagnosed cases, significantly outperforming contact tracing (1%).
- High drug resistance to isoniazid and streptomycin is suspected, though data for new cases is unavailable. Human immunodeficiency virus (HIV) coinfection appears uncommon.
Conclusions:
- Tuberculosis is an increasing public health concern in Siberia, influenced by socioeconomic factors such as homelessness, unemployment, and alcoholism.
- Prisons are identified as a potential significant reservoir for infectious TB cases.
- Despite challenges in diagnostic services, the centralized TB service infrastructure is in place.