ANALYSIS OF SOCIO-DEMOGRAPHIC DETERMINANTS AND RISK FACTORS OF TUBERCULOSIS IN THE ABAI REGION DURING THE PERIOD 2014–2022

Abstract

Introduction: Tuberculosis (TB) remains a major global health challenge, with over 7 million new cases reported in 2022 alone, partially due to pandemic-related disruptions. Despite global progress, drug-resistant forms and co-infections with HIV and diabetes continue to hinder TB control. In Kazakhstan, significant reductions in TB incidence and mortality have been achieved, yet multidrug-resistant TB and regional disparities persist. The Abai region, formed from the former East Kazakhstan area, has shown variable trends that warrant focused analysis. The primary objective of this study was to assess the epidemiological situation of tuberculosis in the Abai region over the period from 2014 to 2022, with a particular focus on identifying key socio-demographic determinants and associated risk factors. Materials and Methods: This retrospective epidemiological study was based on data from Form № TB-03/u of the National Tuberculosis Registry of Kazakhstan (NTR-TB RK) covering the period from 2014 to 2022. The registry includes detailed demographic, clinical, laboratory, and drug susceptibility data on all newly diagnosed and recurrent TB cases. Prior to analysis, the dataset was anonymized, standardized, and coded. Only complete records were included, while those with missing critical data were excluded. Statistical analysis involved incidence calculations, descriptive statistics, and appropriate comparative tests, with significance set at p < 0.05. Results: A total of 3,555 TB cases were registered in the Abai region from 2014 to 2022, with a clear downward trend— from 752 cases in 2014 to 234 in 2022. Most patients were male (61.7%), and pulmonary TB predominated (85%), with infiltrative forms being the most common. Two-thirds of patients resided in urban areas, and nearly half (48.4%) were unemployed at diagnosis. Although no specific risk factors were identified in 84.8% of cases, alcohol abuse, diabetes, prior incarceration, and HIV infection were reported in a minority. Drug-resistant TB was detected in 29.3% of cases, and treatment success (cure or completion) was achieved in over 75% of patients. Conclusion: To sustain and accelerate progress toward TB elimination, it is essential to integrate TB services into broader health and social care systems, with a focus on targeted support for high-risk groups and improved continuity of care across all stages of the treatment cascade.