Tuberculosis

Mortality

2021: 1.5 million people died from tuberculosis

Deaths from coronavirus and other diseases in the world in 2021

Infectious diseases that cause the most people to die or lose health, for 2021

• lower respiratory tract infections;
• HIV/AIDS;
• tuberculosis;
• diarrhoeal diseases;
• malaria;
• measles.

Multidrug-resistant tuberculosis (MDR-TB)

The challenge in TB control for 2021 is multidrug-resistant tuberculosis (MDR-TB). The main causes of MDR-TB are:

• late diagnosis of primary drug resistance of the pathogen,
• inadequate or unfinished previous treatment.

MDR-TB requires more expensive and long-term therapy, and is more often fatal. Another challenge in the fight against the disease is tuberculosis co-infection and HIV infection (TB/HIV). Their share among new cases is increasing annually. So in 2019, the share of patients with co-infection with TB/HIV, from all patients registered for dispensary accounting amounted to 24.7% of cases, and MDR-TB - 29.9% ^[1].

The problem of the emergence and spread of drug-resistant forms of the disease and co-infection with TB/HIV required the development and introduction of laboratory technologies that allow obtaining diagnostic results as soon as possible. Current molecular research methods allow rapid "flow separation" of patients with drug-resistant TB requiring treatment with reserve row drugs and TB, which can be cured with basic row TB drugs. Accelerated diagnostics in liquid media allows you to obtain a detailed characteristic of the pathogen, sensitivity to a wide range of drugs and timely adjust the treatment.

In Russia

2024

Mortality from tuberculosis decreased in Russia six times in 20 years

The implementation of state programs to combat tuberculosis and socially significant diseases has significantly improved the epidemiological situation in Russia. This was announced on October 25, 2024 Minister of Health of Russia Mikhail Murashko at the board of the ministry dedicated to the implementation of state policies in the field of countering socially significant diseases.

According to TASS, the incidence and mortality rates from tuberculosis have reached a historical minimum over the entire observation period. Over the past two decades, the death rate has decreased six times, and the incidence has decreased three times.

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Thanks to the successful implementation of state programs to combat tuberculosis and socially significant diseases, over the past twenty years, the country has managed to reduce the incidence by three times, and mortality by six times, "said Russian Health Minister Mikhail Murashko. He added that the achievement of such results was made possible by a comprehensive approach to solving the problem.

The Ministry of Health of Russia emphasizes the importance of the achieved technological sovereignty and successful import substitution in the field of tuberculosis diagnostics. All main areas of patient examination are provided with domestic developments. The country has established the production of equipment and reagents that ensure the implementation of all the required methods for diagnosing tuberculosis in accordance with regulatory legal acts regulating the fight against this disease. Technological sovereignty has been achieved in the main areas of tuberculosis diagnosis, and import substitution has been implemented.

The board of the ministry also considered the implementation of state policies to counter the spread of HIV infection, the fight against chronic viral hepatitis and sexually transmitted infections.^[2]

The first mRNA vaccine against tuberculosis has been developed in Russia

Specialists from Sirius University have developed an mRNA vaccine against tuberculosis. She has already successfully passed preclinical tests, the press service of the university said in mid-February 2024. Read more here.

2023

48.7% reduction in incidence since 2015

The incidence of tuberculosis in Russia in 2023 compared to 2015 decreased by 48.7% and amounted to 29.6 cases per 100 thousand population. This was reported in the report on the results of the work of the Ministry of Health of the Russian Federation in 2023, prepared for the final meeting of the board of the ministry. The document was published in April 2024.

According to TASS with reference to the report of the Ministry of Health, in 2023, mortality from tuberculosis in Russia amounted to 3.6 cases per 100 thousand people against 9.2 cases in 2015. Thus, we are talking about a decrease in mortality by more than 60%.

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In 2023, a historical minimum of morbidity and mortality rates was reached, [the] leading positions in the world in terms of the rate of decline [morbidity and mortality] were recorded, [an] increase in the coverage of preventive examinations was recorded, the Ministry of Health said in a report.

It follows from it that in 2023 more than 3 billion rubles were allocated from the Russian budget for the purchase of drugs for tuberculosis.

As reported Rospotrebnadzor at the end of March 2024, in Russia for ten years there has been a gradual decrease in the incidence of tuberculosis, but the disease remains a serious problem for domestic health care, the use of modern drugs in most cases leads to complete recovery, and the initial forms of tuberculosis can be completely cured.

According to Rospotrebnadzor, in 2023 more than 1 million newborns in the country were vaccinated against tuberculosis, the annual coverage of newborns with vaccination corresponds to the recommended level - more than 95%.

The incidence of tuberculosis in 2023 decreased in many regions. So, in the Tomsk region, the indicator decreased by 1.3%, in the Altai Territory - by 8%.^[3]

Decrease in morbidity in Moscow by 7%

In 2023, the incidence of tuberculosis in Moscow decreased by about 7% compared to the previous year. At the same time, mortality from this infectious disease in the Russian capital decreased by 33%. Such figures were announced on March 20, 2024 by the Moscow Department of Health.

According to the chief phthisiatrician of Moscow Elena Bogorodskaya, the main epidemiological indicators for tuberculosis continue to decline in the capital. This was made possible by the introduction of a new model of TB care for the population. In particular, the incidence rate of the permanent population in 2023 amounted to 6.3 per 100 thousand inhabitants, which is 3.5 times less than in 2012. Mortality of the permanent population from tuberculosis was recorded at 0.4 per 100 thousand of the population - this is 5 times less than in 2012.

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It is also noted that in Moscow over 10 years (by 2023) the number of children with tuberculosis has decreased by 10 times. Among permanent residents, the indicator does not exceed 1-2 cases per 100 thousand children. The incidence of children with tuberculosis in the capital is almost three times lower than the average in Russia. In 2023, more than 1.9 million minors underwent immunological screening for tuberculosis in Moscow.

According to Bogorodskaya, the priority of TB work is the prevention of the disease among the population, as well as citizens who are at risk. The effectiveness of chemotherapy of severe, previously incurable patients with drug resistance of the causative agent of tuberculosis has been increased.

In Moscow, one of the largest megacities in the world, the prevalence of tuberculosis has become equal to that of rare diseases, which demonstrates the success of long-term systemic work, Bogorodskaya notes.[4]

Ministry of Health: Mortality from tuberculosis in Russia has decreased by 3 times in 10 years

Mortality from tuberculosis in Russia over 10 years has decreased by 3 times. The head of the Ministry of Health Mikhail Murashko announced this in December 2023.

According to Murashko, the incidence of tuberculosis in the Russian Federation has halved in 10 years. By the end of 2023, all patients with tuberculosis are provided with medicines at the expense of the state, said the Minister of Health of the Russian Federation. He also noted that Russia is fully provided with Russian systems for detecting tuberculosis, some of which are included in the WHO list, and new methods of treating tuberculosis are being developed.

Mikhail Murashko announced a reduction in mortality from tuberculosis in Russia by 3 times in 10 years

As Mikhail Murashko emphasized, by December 2023, the priority tasks of the phthisiatic service of the Russian Federation are:

• up to 80% more effective treatment of patients with multidrug-resistant tuberculosis;
• achievement of coverage with preventive examinations for tuberculosis not lower than 73%.

From the operational reports of Rosstat it follows that in January 2023 the incidence was recorded at the level of 2900 cases (+ 10.2% compared to January 2022), in February 2023 - 3500 cases (+ 6.9% by February 2022), and in March 2023 - 3500 cases (+ 5.5% by March 2022).

To determine the reasons for the increase in the incidence, it is necessary to conduct special studies, besides, depending on the region, the reasons may differ, says epidemiologist Vasily Vlasov. He suggested that the COVID-19 coronavirus pandemic influenced the increase in the number of detected cases.

Infections that have spread during the pandemic can only be detected now. The shocks of 2022 may also have some significance, but hardly significant, "Vlasov said.

Experts are confident that a complete victory over tuberculosis infection in Russia is quite achievable. Vaccination continues to play a crucial role in its prevention.^[5]

The head of the Novosibirsk Ministry of Health linked the high incidence of tuberculosis with the legacy of convicts

The Minister of Health of the Novosibirsk Region Konstantin Khalzov, one of the reasons for the high incidence of tuberculosis in the region, called the legacy of convicts. In addition to the historical factor, he also named the climatic one.

Convicts were sent to Siberia, and then prisoners, among whom the spread of tuberculosis was quite high, "he told RBC Novosibirsk.

Head of the Novosibirsk Ministry of Health Konstantin Khalzov

Also, according to Khalzov, the high incidence of tuberculosis is influenced by the climate of Siberia, which is of an unfavorable and especially unfavorable type. It affects human health and the resilience of microorganisms. In addition, the region has a high percentage of TB patients in combination with HIV infection.

The immunodeficiency virus causes immunosuppression in the human body, against the background of which a mass of pathogenic flora develops, including pathogens of tuberculosis, - said the head of the Ministry of Health of the Novosibirsk Region.

The head of the Novosibirsk Ministry of Health stressed that among the first cases of tuberculosis, the majority are residents of villages. There are more men among the sick than women, and also that most of the sick belong to the age category of 18-54 years, the minister added.

The number of newly diagnosed patients with tuberculosis in the Novosibirsk region in 2020 amounted to 2,007 cases, in 2021 - 1,729, in 2022 - 1,619 cases. At the same time, the incidence rate of tuberculosis in the Novosibirsk region per 100 thousand population is 55, which exceeds the level in the Russian Federation by 2.1 times (27.8).

According to data, in Rospotrebnadzor 2021 in the Novosibirsk region In 2021, 1,865 HIV-infected people were registered, the incidence rate was 66.7 per 100 thousand of the population, which is 1.6 times higher than the average for (Russia 40.70).^[6]

2022

The incidence of tuberculosis in Russia has tripled since 2000

The incidence of tuberculosis in Russia decreased almost three times from 2000 to 2022, mortality from this disease - five times. This was announced on March 24, 2023 by the Deputy Minister of Health of the Russian Federation Plutnitsky.

In his opinion, such indicators are the result of the systemic work of the state to combat infection. He noted that the medical support for the treatment of patients remains at a fairly good level.

In Russia, since 2001, there has been a decrease in the incidence of tuberculosis. Currently, the statistics on tuberculosis in our country is the best for the entire historical period and amounts to 31.1 per 100 thousand population. We have reached a historic low and this is an unprecedented success! The most active dynamics of the decline occurred in the last 3-5 years after the introduction of a comprehensive program in the regions, - said Irina Vasilyeva, chief freelance phthisiatrician of the Russian Ministry of Health, whose words are quoted by the press service of the department on March 24, 2023.

The Ministry of Health added that over the past 10 years, the number of cases of chronic tuberculosis has decreased by 4.5 times, and the mortality rate over the past 15 years has decreased by 5.2 times.

Andrei Plutnitsky recalled that in 2021, the World Health Organization (WHO) for the first time in history excluded Russia from the list of countries with a high burden of tuberculosis. According to experts, this is the result of state targeted programs to combat tuberculosis and the systemic work of Russian health care to combat dangerous infection, save lives and the health of citizens. An important role was played by the latest methods for diagnosing tuberculosis, developed and launched into production by Russian specialists. In 2022, the Russian drug for the diagnosis of tuberculosis "Diaskintest" was recommended by the World Health Organization for use around the world.^[7][8]

The incidence of tuberculosis in Moscow decreased by 3 times

In 2022, the incidence rate of tuberculosis of permanent residents of Moscow amounted to 7.1 people per 100 thousand population, which is 3.1 times less than in 2022. This was announced in March 2023 by the chief phthisiatrician of the Moscow Department of Health, director of the Moscow City Scientific and Practical Center for the Fight against Tuberculosis Elena Bogorodskaya at a press conference "Successes of Moscow Phthisiatry," which took place as part of World TB Day.

It is noted that the value of the incidence rate of tuberculosis of the permanent population in the city of Moscow is at the incidence rate in countries such as Spain (7.1), Belgium (7), Saudi Arabia (7.2) and lower than in Japan (9.2), Croatia (10), Malta (10.3) and Portugal (14.2).

The incidence of tuberculosis in Moscow over 10 years has decreased by 3 times

The prevalence of tuberculosis among the permanent population of the capital in 2022 decreased by 9.3% and amounted to 10.2 per 100 thousand population (since 2012, the figure has decreased by 5.3 times). Mortality from tuberculosis decreased by 22.6% over the year and amounted to 1.1 per 100 thousand population (since 2012 it has decreased by 3.1 times).

The Moscow Department of Health said that all epidemiological indicators for tuberculosis in Moscow are significantly lower than the average for Russia. Thus, the incidence of tuberculosis of the permanent population in Moscow is 3.6 times lower than the average in Russia, the prevalence of tuberculosis of the permanent population in Moscow is 6.1 times less than in the country, and the mortality rate is 4 times lower.

Tuberculosis is quite rare among Muscovites today. Especially among those who follow the recommendations of phthisiatricians: inoculates newborn children, undergoes an annual preventive examination for tuberculosis. Such indicators were achieved thanks to the strengthening of the main measures to prevent the spread of tuberculosis and the introduction of new technologies, Bogorodskaya said.[9]

2021

In Russia, the incidence of tuberculosis has reached a historical minimum

In 2021, the incidence of tuberculosis in Russia decreased by 4% compared to 2020 and reached a historic low. This was announced on March 24, 2022 by the Minister of Health of Russia Mikhail Murashko.

According to him, in 2021 the incidence of tuberculosis in 2021 amounted to 31.2 per 100 thousand population. The head of the Ministry of Health of the Russian Federation noted that the decrease in the indicator occurred, including among the socially vulnerable segments of the population, as evidenced by a decrease in the proportion of tuberculosis patients newly identified in penitentiary institutions to 6.8%. The incidence has roughly halved since 2010.

In 2021, the incidence of tuberculosis in Russia decreased by 4%

Murashko also said that thanks to a quick and prompt restructuring of work in the context of responding to the COVID-19 coronavirus pandemic, it was possible to maintain the implementation of a set of medical, diagnostic and preventive measures in the field of combating tuberculosis in almost full.

The head of the Ministry of Health of the Russian Federation said that the level of coverage of the population with preventive examinations for tuberculosis is returning to the pre-pandemic level and, according to preliminary data, in 2021 amounted to 71.3%. At the same time, the indicators of coverage of children with tuberculosis testing during preventive examinations exceed 87%. the practice of the phthisiatic service introduced new clinical guidelines for tuberculosis in adults and children.

Data on the situation with tuberculosis in the regions at the end of 2021 by the end of March 2022 were not disclosed. Only the Ministry of Health of the Sverdlovsk Region reported that in the region the mortality rate from this disease was 7.2 cases per 100 thousand people. This is 7.7% less compared to 2020. The region recorded a historical minimum of mortality from this disease over the entire observation period, the department said.^[10]

LG agreed to create a production of tuberculosis tests in Russia for 350 million rubles

In September 2021, LG agreed to create a production of tuberculosis tests in Russia. The corresponding agreement was concluded with the seaside LLC Eurasia. The volume of investments in the project, which will be implemented with the support of Primorsky Krai Development Corporation JSC, will amount to 350 million rubles. Read more here.

2019: 7.5 thousand people died from tuberculosis

According to the Ministry of Health of the Russian Federation, in 2019, and Russia revealed a record low number of patients with tuberculosis - 60.5 thousand, 7.5 thousand people died. In the country as a whole, the incidence rate was 41.2 cases per 100 thousand population.

According to data, the WHO number of cases of tuberculosis in Russia for the period from 2000 to 2019 decreased by more than 2 times (from 133,229 in 2000 to 60,531 in 2019), and deaths from tuberculosis - more than 4 times (from 29,966 in 2000 to 7,264 in 2019), which experts claim is the result states of prioritizing the problem of tuberculosis.^[11]

According to WHO, the number of cases of tuberculosis in Russia for the period from 2000 to 2019 decreased by more than 2 times

According to the Ministry of Health, by October 2019, the mortality rate from tuberculosis in Russia decreased to a national minimum and amounted to 5.1%. According to the ministry, the best mortality rate from tuberculosis for the entire Soviet period was 7.7%.

Russia has become one of the 20 countries with the worst tuberculosis situation, and is also in the top three states where the number of patients with stable forms that do not succumb to conventional therapy is growing.

Leaders in TB incidence in 2019:

• Chukotka - 136.9 cases per 100 thousand population;
• Tuva - 119.3 cases;
• Kemerovo region - 93.7 cases;
• Primorsky Territory - 93.4 cases,
• Jewish Autonomous Region - 91.9 cases.

The lowest number of newly detected cases of tuberculosis per 100 thousand population in 2019 was recorded by the Ministry of Health in the Nenets Autonomous Okrug - 4.6. A low incidence rate was noted in Belgorod (14.2), Vologda (14.9), Ryazan (16.5) regions, as well as in Arkhangelskaya (20) and Murmansk (20.6) regions.

From 21.1 to 22.1 cases per 100 thousand population were registered in the Oryol region, Karelia, Kostroma and Voronezh regions.

In Moscow and St. Petersburg in 2019, 22.6 and 25.9 newly detected cases of tuberculosis per 100 thousand population were recorded, respectively.

1929

1920s (?)

In the world

2023: TB incidence rises in US

The incidence of tuberculosis has increased in the United States. This is stated in a report by the Centers for Disease Control and Prevention (CDC), published in March 2024.

Despite the fact that the United States has one of the lowest TB cases in the world, researchers note a 16% increase in incidence in 2023 compared to 2022. In 2023, the study notes, about 9,600 cases of tuberculosis were reported, compared with 8,300 cases in 2022. Prior to this, the incidence has been steadily decreasing over the past three decades.

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Post-pandemic [we are talking about the COVID-19 coronavirus pandemic] the increase in cases in the United States emphasizes the importance of working with communities with a higher incidence of tuberculosis in the fight against tuberculosis, as well as the importance of strengthening public health programs, the report says.

Researchers note that TB programs have been affected by the COVID-19 pandemic, as TB programs have been stripped of resources to combat the pandemic. In addition, the difficulties of the health care system have led to the fact that tuberculosis has ceased to be diagnosed and treated in time.

76% of Americans with tuberculosis were born outside the United States. Among those born in the US, Hawaiians and other Pacific islanders have the highest rates of TB. In addition, Native Americans and Alaska Native peoples are more affected by tuberculosis.

Geographically, tuberculosis is most common in Alaska - there are 10.6 cases per 100 thousand people. In addition, Hawaii, California, New York and Texas were among the five most "tuberculosis" regions in the United States.

The CDC report also recalls that not all TB cases are "open" and contagious. Most cases of tuberculosis in the United States are associated with the activation of a "latent" bacterium sitting inside the human body.^[12]

2022: The incidence of tuberculosis is on the rise worldwide

In 2022, 7.5 million newly diagnosed cases of tuberculosis were registered worldwide, which is a record high since 1995. This is stated in the report of the World Health Organization (WHO), which is presented on November 7, 2023.

The statistics are based on data from 192 countries and regions: this is mainly information from the ministries of health of the countries that provided the information. According to estimates, from 2021 to 2022, the total number of patients with tuberculosis on a global scale increased from 10.3 million to 10.6 million people. The largest number of new cases of tuberculosis was recorded in the regions of Southeast Asia (46%), Africa (23%) and the Western Pacific (18%). The least cases are in the regions of the Eastern Mediterranean (8.1%), the countries of America (3.1%) and the European region (2.2%).

7.5m newly diagnosed TB cases reported worldwide

At the same time, a decrease in mortality from tuberculosis was recorded. The total number of deaths due to this disease (including among people with HIV) in 2022 amounted to about 1.3 million. For comparison: a year earlier, the figure reached 1.4 million. Nevertheless, the report emphasizes, in the period from 2020 to 2022, interruptions associated with the COVID-19 pandemic led to an increase in the number of deaths from tuberculosis by almost half a million people. Tuberculosis remains the leading cause of death among people with HIV. In 2022, tuberculosis with multidrug resistance or rifampicin resistance (MDR/RU-TB) developed in 410 thousand people, but only two out of five patients received the necessary treatment.

For the period from 2015 to 2022, the net decrease in mortality from tuberculosis was 19%, and the total reduction in morbidity was 8.7%. About 50% of TB patients and their households incur catastrophic combined costs - direct medical and non-medical costs, including a loss of income of more than 20%.^[13]

Tuberculosis vaccinations

2020: Vaccination against tuberculosis reduces by 80% the chances of contracting COVID-19

In early September 2020, the Netherlands announced that it would begin testing a vaccine against tuberculosis, which is supposed to protect vulnerable populations from respiratory infections, in particular, from the coronavirus. Thousands of pensioners with a weakened immune system, who are at high risk during the coronavirus pandemic, will take part in the testing.

Vaccination against tuberculosis reduces by 80% the chances of contracting coronavirus

Two new studies have provided promising results. According to the researchers, the Calmette-Guerin vaccine, also known as the BCG vaccine, can be used to increase resistance to Covid-19. One study led by Mihai Netea of Radboud University Medical Center in the Netherlands shows that older adults vaccinated with BCG are 80% less likely to contract a respiratory tract infection than people who have not received vaccinations. Another example was provided by a group of medical workers from the United Arab Emirates: they noted that patients vaccinated with BCG did not become infected with Covid-19, unlike the unvaccinated control group.

However, the direct protective effect of the BCG vaccine against coronavirus has not yet been proven. The Dutch project will study this aspect, which starts in early September. Researchers have until the end of October to recruit up to 7,000 elderly patients for the study, with results not expected until six months later. The project will be led by Mihai Netea and Marc Bonten from the University Medical Center in Utrecht. They hope that the old BCG vaccine, developed more than a century ago, will help overcome the period before the release of new drugs and vaccines against coronavirus and protect people who are most at risk.^[14]

Treatment of tuberculosis

"Ancient" solarium

Painful and frail children, especially patients with tuberculosis, were sent under a special lamp so that vitamin D produced in the skin could help fight disease and bacterial infections]]

World TB Day

Every year, World Tuberculosis Day is held on March 24 in honor of the discovery in 1882 by Dr. Robert Koch of the causative agent of tuberculosis, which was a scientific breakthrough in the fight against the epidemic.

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