Medical and social structure of patients with newly diagnosed and recurrent pulmonary tuberculosis detected in Yakutia in 2020

The article presents the structure of newly diagnosed and recurrent pulmonary tuberculosis registered in the districts of the Sakha Republic (Yakutia) in 2020, based on the analysis of medical records of 146 new cases of respiratory tuberculosis, including 110 newly diagnosed and 36 relapses. When distributing patients by age and sex, it was found that men (61.8-77.8 %, respectively) of the most able-bodied age of 30-49 years predominate both among newly diagnosed patients and among relapses. According to the place of residence, both among the newly diagnosed and among the relapses, rural residents prevailed at 69.2 %, with urban residents making 30.8 %. When distributing the patients by districts of the republic, agricultural regions (50.7 %), industrial (28.8 %) and Arctic regions (20.5 %) prevailed. When examining the timing of the passage of a fluorographic (FLG) study, it was revealed that 58.2 % of those newly diagnosed underwent annual FLG, with a relapse – 91.7 %. Missing FLG for 2-3 or more years among newly diagnosed patients was observed in non-working working-age people with alcohol dependence. It was noted that the cases of newly diagnosed tuberculosis were more often detected during FLG examination – 60.9 %, and the relapses much – more often (in 72.2 %) when seeking treatment, with complaints mainly about prolonged cough, fever, shortness of breath. Infiltrative and disseminated tuberculosis occurs equally in newly diagnosed patients (44.5 % and 28.2 %) and patients with relapse (50 % and 19.4 %). Bacterial excretion was detected in the majority of the patients equally in both newly diagnosed (69.1 %) and relapses (70.5 %). At the same time, drug-susceptible (DS) and drug-resistant (DR) MBT occurred in equal proportions in newly diagnosed patients – 51.3 % and 48.7 %. Among those newly diagnosed, resistance to HR+ reserve drugs was more common in 40.5 % of patients; in the patients with relapses, resistance to HR+ of the main and reserve anti-TB drugs prevailed in 51.9 % of thecases. XDR MBT were detected in isolated cases (2.7-7.4 %) both among newly diagnosed and patients with relapses.

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