Features of tuberculosis incidence in the elderly in modern epidemiological conditions
The аim . To study the incidence of tuberculosis and the formation of its structure among the elderly in Russia, the Central Federal District and the Yaroslavl Region, in dynamics for 2014–2023. Materials and methods . Data from the Federal statistical observation form No. 8 and Rosstat data on the population of Russia, for 2014–2023. The Statistica 15.0 software and spreadsheets in Excel 2019 format were used for the analysis. The differences were recognized as significant at a value of p<0.05. Results and discussion . Despite the decrease in the incidence of TB in 2014–2023 in Russia, the Central Federal District and the Yaroslavl Region, the proportion of patients aged 65 years and older in the structure of newly diagnosed TB patients increased 1.5–1.9 times during this time. Respiratory TB prevailed among patients of this age group, and the proportion of extrapulmonary forms of TB in Russia and the Central Federal District did not exceed 6–7%, and in the Yaroslavl region in 2020, 2022, 2023, not a single patient with extrapulmonary forms of TB was identified. This situation indicates a decrease in alertness among doctors of various specialties regarding the detection and diagnosis of extrapulmonary forms of TB among the elderly. The detection of common forms of TB with bacterial excretion in half of patients aged 65 years and older, both in Russia, the Central Federal District and the Yaroslavl region, indicates serious shortcomings in the organization of screening among the older age groups of the population. The late diagnosis of TB and the high epidemic risk of TB spread among the elderly are also indicated by the increase in the proportion of postmortem TB cases, which increased by an average of 1.5 times in Russia and the Central Federal District from 2014 to 2023, and ranged from 0 to 14.8% in the Yaroslavl Region. Conclusion . Currently, in Russia, the Central Federal District and the Yaroslavl region, there is a shift in the epidemic process towards older age groups, which indicates the increasing importance of the cohort of elderly patients in the formation of the TB incidence rate. In this regard, there is an urgent need to improve organizational approaches to the organization of screening aimed at early detection of TB among older age groups of the population.