Structured tb risk factors in regions with low and high population density

Abstract

In Russia, socio-demographic, health care management, climatic and environmental TB risk factors such as population density, intensity of social contacts, availability of medical care, seasonal climate changes, environmental issues affecting quality of public health have been holding the leading place while a life standard elevates, and epidemic situation becomes improved. However, the magnitude of specific population density-related TB risk factors in the Russian regions has not been examined yet. The study aim was to assess structured TB risk factors in the Russian regions with high and low population densities decreasing public health quality. Materials and methods. There was conducted a study using sociological, cluster-quota approaches, with respondent-based sample and a face-to-face distribution questionnaire provided by 2500 subjects, of which 1497 were from the North Ossetia-Alania Republic with a high population density, 1003 - from the Republic of Karelia with a low population density. A significance of differences was assessed by using exact criterion Fisher using a contingency table. Results. In the Republic of Karelia, compared with North Ossetia-Alania Republic, despite a higher gross regional product (527.8 thousand rubles vs. 293.4 thousand rubles, p0.000), social and behavioral TB risk factors were significantly elevated: fewer respondents with high education (18.4% vs. 33.6%, p0.000), higher divorced (18.7% vs. 26.9%, p0.022), higher number of those living in apartment buildings (65.0% vs. 39.5%, p0.000), more hired and seasonal workers, unemployed, pensioners due to age and disability (55.0% vs. 32.3%, p0.000), more alcohol abusers (67.4% vs. 34.3%, p0.000), “heavy” smokers (20.8% vs. 7.2%, p0.000), more subjects with chronic diseases (43.7% vs. 32.1%, p0.02); more issues related to accessibility to medical care: municipal policlinics are less available (42.7% vs. 85.6%, p0.000), the distant location of medical facilities (21.4% vs. 2.7%, p0.000) , lack of transport links (15.7% vs. 8.5%, p0.000), poor roads (5.9% vs. 16.9%, p0.000) and few medical specialists (60.9% vs. 16, 8%, p0.000) are more often noted. In the North Ossetia-Alania Republic vs. the Republic of Karelia, respondents had more frequent social contact with TB patients (66.9% vs. 34.8%, p0.000). Conclusion. The epidemiological TB factors in the Russian regions with high population density hold a lead place; in regions with low population density, social, behavioral and accessibility to medical care factors remain relevant, which should be taken into account while developing measures for efficient management of epidemic process.