Improving the organization of tuberculosis detection using an organizational and functional model.

Abstract

With a decrease in the incidence of tuberculosis (TB) observed in Russia and 2/3 of the subjects of the Russian Federation (RF) in recent years, the organization of mass periodic examinations aimed at early detection of TB among the population has become less effective, since to identify one TB patient it was necessary to examine an increasing number of people who had no signs of TB disease. In this regard, in the regions of the Russian Federation where the incidence of TB is steadily decreasing, examinations should focus on those population groups that have an increased risk of TB disease. Objective: development of an organizational and functional model aimed at early detection of tuberculosis among the population and in high-risk groups, in conditions of reducing the incidence of tuberculosis. Materials and methods. Information from Federal statistical observation forms No. 8 and No. 30 and Rosstat population data for the Kaluga Region for 2019–2024. For mapping and cluster analysis, the general distribution of TB cases (n=459) identified in municipal districts (n=26) of the Kaluga Region in 2019–2023 was studied. Mapping and spatial analysis were carried out using QGIS, a free and open Source geographic Information System, v. 3.36.1 (https://qgis.org/ru/site /) and Statistica, a software package for statistical analysis developed by StatSoft, copyright holder TIBCO (USA) (https://www.tibco.com /). The StatTech v program was used for the analysis.2.8.8 (developed by Stattech LLC, Russia). The differences were considered significant when the value was <0.05. Results. To organize early detection of TB among the population and in high-risk groups in the subjects of the Russian Federation, where the incidence of TB is steadily decreasing, an organizational and functional model (OFM) was developed, which is an integrated organizational structure in which all elements of interdisciplinary interaction between the TB service and medical organizations providing primary health care are interconnected, starting with the planning of inspections using methods of cartographic and cluster analysis, and before their implementation using organizational measures of a multi-level complex. The results of the implementation of OFM organizational measures in the Kaluga Region in 2023–2024 have shown their high effectiveness, due to a significant increase in the coverage of examinations of the population and high-risk groups, and an increase in the proportion of timely identified TB patients in high-risk groups, which led to a significant reduction in the reservoir of TB infection in the Kaluga region. Conclusion. The development and implementation of an organizational and functional model in the subjects of the Russian Federation, where the incidence of TB is steadily decreasing, has made it possible to increase the effectiveness of periodic examinations aimed at early detection of TB among the population and in high–risk groups.