TUBERCULOSIS: PREVALENCE, RISK FACTORS, AND FIRST-LINE DRUG RESISTANCE

Abstract

Introduction: In Kazakhstan, according to the National Center of Phthisiopulmonology, there has been a decrease in tuberculosis (TB) incidence, though the issue remains significant. TB is more common among socially vulnerable groups, including the homeless, prisoners, migrants, and individuals with weakened immune systems. The average TB incidence rate in the country is around 55 cases per 100,000 people, which is higher than the Central Asia average. Aim of the literature review is to analyze TB prevalence worldwide and in Kazakhstan, with attention to key sociodemographic data, risk factors, and multidrug-resistant forms. Search Strategy: After identifying primary keywords and synonyms, a literature search was conducted in English (PubMed, Google Scholar, Embase) and Russian databases (Cyberleninka, eLibrary), covering the past seven years for relevance. Selected publications underwent citation analysis, and abstracts were screened for relevance. Studies meeting inclusion criteria were then retrieved in full for detailed review. Inclusion criteria: studies pertinent to the topic, in English or Russian, published since 2017, including primary/secondary research, systematic reviews, meta-analyses, clinical guidelines, monographs, and conference abstracts. Results and Conclusion: According to the World Health Organization (WHO), over 10 million new active TB cases are recorded annually. In Kazakhstan, the TB incidence rate in 2022 was 78 cases per 100,000 population. Although TB incidence has been decreasing in the country, the disease burden remains significant, particularly within specific regions and population groups. In 2019, Kyzylorda Region reported the highest incidence at 115 per 100,000, while the lowest rate, 55 per 100,000, was observed in Karaganda Region and its surrounding areas. These disparities may be due to differences in income, living conditions, population age, and comorbidities. A critical issue also remains the prevalence of multidrugresistant TB (MDR-TB): approximately 25% of new cases and nearly 50% of previously treated patients are resistant to firstline medications. The government of Kazakhstan is actively working to combat TB, achieving significant progress in reducing prevalence and improving treatment outcomes.