Monitoring of Tuberculosis Outbreaks with Assessment of the Scope and Effectiveness of Anti-Epidemic Measures

The objective: to evaluate monitoring of tuberculosis outbreaks to obtain information on the spread of tuberculosis infection in the region, assess the effectiveness of preventive measures in the infection foci and determine the amount of resources required for this.

Subjects and Methods. Data for 2023-2024 were analyzed. The data were obtained from registers of outbreaks (5,554 outbreaks registered in the city) and the register of dispensary follow-up (5,675 tuberculosis patients registered in the city), developed by Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health, and implemented in Moscow.

Results. Of 5,554 tuberculosis outbreaks registered in Moscow, 3,242 (58.4%) were household ones, with a prevalence of 12 cases per 100,000 population, of which 29.6% were formed by tuberculosis (TB) patients with a positive result of the sputum test, and 39.5% by non-permanent residents of the city. In the outbreaks, 92 cases of active tuberculosis were detected among close contacts. Of these, 3 cases were detected during a repeated examination of contacts from Dispensary Follow-up Group IV. This rate reflects the incidence of tuberculosis in outbreaks after preventive measures were carried out by a district phthisiologist, which equals to 5.1 (95% CI: 1.1-14.9) per 100,000 people registered in Dispensary Follow-up Group IV. 87 patients fell ill with tuberculosis before the outbreak was detected by a phthisiologist; they were detected during the first screening of the exposed people. The indicated number determined the natural course of the tuberculosis epidemic process – the incidence in outbreaks before its detection by phthisiologists made 1561 (95% CI: 1252-1922) per 100,000 examined contacts from the immediate environment of the patient. Tuberculosis patients who were permanent residents had fewer contacts in the immediate environment than those who belonged to the non-permanent population: 1.78±0.04 and 2.25±0.12, respectively (p<0.01). Tuberculosis patients aged 18–40 years, who were permanent residents had significantly more contacts than patients over 40 years old: 2.13±0.08 versus 1.59±0.05, respectively (p<0.01). The number of detected outbreaks formed by one patient varied from 0.4 to 1.3 in the patients of different population groups. The proportion of patients with detected outbreaks is 64.5% (95% CI: 63.3-65.8%) overall, and 91.8% (95% CI: 90.4-93.1%) among permanent residents. Among the outbreaks that phthisiologists worked with, 17.7% turned out to be false.

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