EPIDEMIOLOGICAL ASPECTS OF TUBERCULOSIS IN ADOLESCENTS

Abstract

Relevance: Adolescents, due to biological, anatomical, physiological, psycho-emotional and social factors, are one of
the most vulnerable groups of the population for tuberculosis. The current conditions of epidemiological problems with
adolescent tuberculosis in the region served as the basis for this study.
The purpose of the study: to conduct a comparative analysis of the structure of tuberculosis in adolescents of the
Semey region over the past decade.
Materials and methods: A retrospective analysis of the data of the medical information system "National Register of
Tuberculosis Patients" of the Municipal state enterprise on the right of economic management at the Regional Center for
Phthisiopulmonology and Rehabilitation of the health department of East Kazakhstan region was carried out. Design is a
cross-sectional study. Inclusion criteria: adolescents from 15 to 18 years of age, pulmonary tuberculosis. Exclusion criteria: children from 0 to 15 years old, adults 18 years and older, tuberculosis of extrapulmonary localization. A total of 187
adolescents were included in the study by the continuous sampling method: the first group - 138 (tuberculosis was detected
in 2011-2015), the second group - 49 (tuberculosis was detected in 2016-2020). Statistical analysis was carried out using the
StatTechv program. 2.5.9 (developer - Stattech LLC, Russia).
Results: The dynamics of tuberculosis incidence among adolescents over the past decade shows a downward trend.
The structure of tuberculosis in adolescents of the second group, compared with the first, was dominated by females (65.3%
vs. 42.8%; p=0.007), urban residents (85.7% vs. 68.8%; p=0.022), students (36.7% vs. 20.3%; p=0.038). The proportion of
destructive (22.5% and 36.7%) and drug-resistant (35.5% and 36.7%) forms of the disease had no statistically significant
differences (p=0.051 and p=0.878, respectively). The introduction of the molecular genetic method Xpert MTB/RIF increased
laboratory confirmation of tuberculosis in adolescents by 4 times from 14.5% to 61.2% (p=0.001). The results of treatment in
the analyzed groups showed high efficiency and amounted to 96.4% and 96.0%, respectively (p=0.529).
Conclusions: In order to further improve the epidemiological situation in the region, it is necessary to implement highquality measures for the diagnosis, prevention and treatment of tuberculosis among the adolescent population, taking into
account the latest WHO recommendations and regulatory documents on tuberculosis control in the Republic of Kazakhstan.