Epidemiology of tuberculosis in Kazakhstan: data from the Unified National Electronic Healthcare System 2014–2019

Abstract

ObjectivesThis study aims to estimate tuberculosis (TB) incidence, mortality rates and survival HRs in Kazakhstan, using large-scale administrative health data records during 2014–2019.DesignA retrospective cohort study.SettingsData for patients with TB in Kazakhstan during 2014–2019, reported in the Unified National Electronic Healthcare System.ParticipantsPatients with TB in Kazakhstan (ICD-10 (The International Classification of Diseases, 10th revision) codes: A15–A19).Outcome measuresDemographic factors, diagnoses and comorbidities were analysed using descriptive, bivariate and multivariable statistical analyses. TB incidence and mortality rates were calculated, and Cox regression and Kaplan-Meier survival analysis were performed to assess risk factors for survival rates.ResultsOf the 149 122 patients with TB, 91 437 (61%) were males, and 139 931 (94%) had respiratory TB. From 2014 to 2019, TB incidence declined from 227 to 15.2 per 100 000 individuals, while all-cause mortality increased from 8.4 to 15.2 per 100 000. Age-specific TB incidence was lowest for 0–10 years of age and highest for 20 years of age. Being older, man, urban residence versus rural, retired versus employed, having HIV and having diabetes versus no comorbidities were associated with lower survival rates.ConclusionTo date, this is the largest TB published study for Kazakhstan, characterising TB incidence and mortality trends by demographic factors, and risk factors for survival rates. The findings highlight the need for targeted interventions to address the growing burden of TB, particularly among older adults, men, urban residents and those with HIV and diabetes. The study underscores the importance of using administrative health data to inform policy and health system responses to TB in Kazakhstan.

Vitamin D Status, VDR, and TLR Polymorphisms and Pulmonary Tuberculosis Epidemiology in Kazakhstan

“…Despite the low population density, the incidence of pulmonary TB (PTB) in Kazakhstan is the highest among CIS countries. In the last decade, TB incidence in Kazakhstan has declined from 227 per 100,000 individuals in 2014 to 81.7 per 100,000 individuals in 2018 and to 36.5 per 100,000 individuals in 2022, while mortality has increased from 8.4 to 15.2 per 100,000 individuals [ 19 ]. Kazakhstan has one of the highest numbers of multi-drug resistant TB (MDR-TB) patients in the world.…”

Pulmonary tuberculosis epidemiology and genetics in Kazakhstan

“…The effectiveness of treatment of TB patients in Kazakhstan reached one of the highest indicators in the world. In 2021, the treatment effectiveness of newly diagnosed patients with sensitive TB was 85.9%, and with drug resistance -80.2% (6). The government putting an enormous effort into fighting against TB, but cases involving drugresistant strains of MTB dramatically increased in Kazakhstan.…”