Higher School of Economics, International Laboratory for Landscape Ecology, Myasnitskaya ulitsa 20, Moscow 101000, Russia.
FGBI Federal Center for Animal Health (FGBI ARRIAH), mkr. Yurevets, Vladimir 600901, Russia.
Spat Spatiotemporal Epidemiol. 2023 Jun;45:100580. doi: 10.1016/j.sste.2023.100580. Epub 2023 Feb 1.
Our study investigated the spatial distribution of tuberculosis and the influence of social determinants in Russia between 2006 and 2018 using the regional incidence of multi-drug resistance tuberculosis, HIV-TB coinfection, and mortality data. The "space-time cube" method identified the uneven geographical distribution of the tuberculosis burden. There is a clear distinction between a healthier European Russia, where a statistically significant stable trend towards a decrease in incidence and mortality was found, and the eastern part of the country, where there is no such trend. Generalized linear logistic regression analysis found that the challenging situation was associated with HIV-TB coinfection incidence, with a high incidence rate being detected even in more prosperous regions of European Russia. HIV-TB coinfection incidence was determined by a set of socioeconomic variables, out of which the influence of income and urbanization were the most pronounced. The influence of crime could indicate the spread of tuberculosis in socially disadvantaged regions.
我们的研究利用 2006 年至 2018 年期间耐多药结核病、HIV-TB 合并感染和死亡率的区域发病率数据，调查了俄罗斯的结核病空间分布及其社会决定因素的影响。“时空立方体”方法确定了结核病负担的不均匀地理分布。在更为健康的欧洲俄罗斯地区，发病率和死亡率呈统计学意义上的稳定下降趋势，与这种趋势不存在的国家东部地区之间存在明显区别。广义线性逻辑回归分析发现，这种严峻的情况与 HIV-TB 合并感染的发病率有关，即使在欧洲俄罗斯较为繁荣的地区也发现了高发病率。HIV-TB 合并感染的发病率由一系列社会经济变量决定，其中收入和城市化的影响最为显著。犯罪的影响可能表明结核病在社会弱势群体地区的传播。
