Tuberculosis in Belarus at the turn of and at the beginning of the 21st century: epidemiology, problems, challenges

Based on the statistical materials of the analytical report, the data of the register of results of “Tuberculosis” and scientific research, the analysis of the prevalence of tuberculosis in Belarus at the turn of the 21st century and in the first quarter of the 21st century was carried out. The epidemiological situation of tuberculosis in the period 2000—2005 was alarming: the incidence rate was 49.9—54.3 per 100 thousand of the population, the mortality rate was 7.3—12.1 per 100 thousand. This required the adoption of legislative measures at the state level. Program-targeted planning of tasks to combat tuberculosis in the framework of the implementation of state programs to ensure the achievement of epidemiological situations. By 2019, the incidence of tuberculosis decreased by 65.8 % (18.6 per 100 thousand), the mortality rate from tuberculosis — by 81.8 % (2.2 per 100 thousand). The achieved positive dynamics of the main epidemiological indicators for tuberculosis were disrupted by the COVID-19 pandemic. The detection of tuberculosis has sharply decreased due to serious examinations. After exiting the pandemic (2022), the system of preventive medical examinations was restored, new medical technologies for diagnostics and chemotherapy, strict monitoring of tuberculosis and control over the development of the epidemiological situation were developed and introduced into practice. However, a serious problem in phthisiology remains the prevalence of multidrug-resistant tuberculosis, accounting for 36.2 % among new cases and 61.0 % among treated patients, as well as in combination with HIV infection (13.5 %) and viral hepatitis C. (19.7 %). A deterrent to ensuring the best results in stopping the spread of tuberculosis is the relapse of the disease, among which in 85.0 % of cases the isolation of bacteria with multidrug resistance of the pathogen was diagnosed. The incidence of tuberculosis, taking into account relapses in 2023, is 16.8 per 100 thousand population, mortality is 0.96 per 100 thousand population.

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