Tuberculosis - I.T. Pyatnochka 2005

Epidemiological situation of tuberculosis in Ukraine

Looking back at the past, from 1965 to 1990 the incidence of all Clinical forms of tuberculosis in Ukraine decreased 3.6-fold—from 115.4 to 32.0 per 100,000 population; over the same years, mortality dropped 3.3-fold—from 27.1 to 8.1 per 100,000 population. However, 1990 marked a turning point in the epidemiological situation regarding tuberculosis, triggering an upward trend clearly reflected in epidemiological indicators.

The epidemiological situation of tuberculosis is assessed using such indicators as incidence, prevalence, mortality, and infection rate. Incidence refers to the number of newly diagnosed active tuberculosis cases registered within a year per 100,000 population.

The incidence of all forms of tuberculosis in Ukraine surged from 32 to 77.5 per 100,000 population (a 142.2% increase) between 1990 and 2003. In 2003, Ukraine had 660,022 registered tuberculosis patients, accounting for 1.4% of the total population.

The tuberculosis process complies with the general laws of the epidemiological process and arises and is sustained only through the interaction of three core links: the source of infection, The Mechanism of transmission, and host susceptibility to tuberculosis.

Prevalence refers to the total number of active tuberculosis patients under dispensary observation in healthcare facilities at the end of the year, calculated per 100,000 population.

Mortality is the number of deaths caused by tuberculosis within a year per 100,000 population.

The infection rate is another key metric used to evaluate the epidemiological situation of tuberculosis. Tuberculosis infection rate is defined as the percentage of individuals with a positive tuberculin Skin test among those examined, excluding individuals with post-vaccination allergy.

Under current epidemic conditions in Ukraine, the tuberculosis infection rate is 9% among children aged 7–8 years and 20% among those aged 13–14 years. By the age of 40, the infection rate reaches 80–90%. Consequently, the population's infection rate varies and increases year by year, driven by multiple factors: the tuberculosis prevalence among the population, living conditions, the general and sanitary culture of the population, and the state's active efforts in combating tuberculosis.

Meanwhile, WHO experts envision and propose the following Criteria for the elimination of tuberculosis as a widespread disease: the detection of no more than one sputum-smear-positive case per 10 million population per year, an overall incidence of up to 20 per 100,000 population, and an infection rate among 14-year-olds of no more than 1%.