Basic principles of population screening for tuberculosis

Abstract

Purpose: to highlight the basic principles of organizing and conducting screening of the population for tuberculosis by doctors of general practice - family medicine based on the world experience and Ukraine and the results of modern research on the example of the Chernihiv region. Materials and methods. Content analysis (qualitative-quantitative method of studying documents), information-analytical (system of logically consistent methodological, organically consistent procedures), bibliosemantic (study of specialized modern international literature on the researched problem) was used. Results. Currently, tuberculosis is an urgent medical and social problem not only in Ukraine, but throughout the world. Every year, 8–10 million new cases of the disease are registered and 3–4 million people die, 5–7% of children add to the number of people infected with the causative agent of tuberculosis. Ukraine leads the list of leaders of the tuberculosis epidemic, and high rates of resistance to anti-tuberculosis drugs are found. A tuberculosis epidemic has been registered in the country since 1995. Screening for tuberculosis can be aimed at detecting active tuberculosis or latent tuberculosis infection. People with latent TB infection have no symptoms of the disease, but are at risk of reactivation of active TB, sometimes for decades. Latent tuberculosis infection can be detected using tuberculin skin tests or gamma interferon release assays. Screening for active pulmonary tuberculosis usually includes a chest x-ray. It is important to raise awareness about tuberculosis among specialists and the public. The TB Action Plan for England 2021-2026 recognizes that screening for latent and active TB, together with awareness-raising measures, will help reduce the incidence of TB in England. You can observe the incidence rates of each region of Ukraine. In general, the incidence of active tuberculosis, including its recurrences, is 45.1 per 100,000 population throughout the country. The incidence of active tuberculosis, including its recurrences, in the Chernihiv region is 43.4 per 100,000 population in 2022, and 56.2 per 100,000 population in 2021. Increased awareness makes health professionals and members of the public more attentive to the epidemiology and various clinical manifestations of tuberculosis. This is important because: tuberculosis can occur in different forms; the onset of tuberculosis is not always clear; typical symptoms are not always detected. The incidence of active tuberculosis among the entire population of Chernihiv region decreased by 12.8%. Since the Chernihiv region suffered during the active hostilities, the "Chernihiv regional anti-tuberculosis dispensary" was completely destroyed, which made the diagnosis and treatment of tuberculosis more difficult. Factors that affected epidemiological data during active hostilities on the territory of the country in 2022: damage to antituberculosis dispensaries in 9 regions; insufficient funding of anti-tuberculosis services; deterioration of sanitary conditions in war zones; lack of sufficient control over taking anti-tuberculosis drugs, lack of proper monitoring of treatment of patients from the districts. Conclusions. According to the Center for Public Health, the number of newly registered tuberculosis cases in Ukraine in 2022, including its recurrences, was 18,510, or 45.1 per 100,000 population, which is 2.5% more than in 2021 (18 241, or 44.0 per 100,000 population).