Dynamics of the epidemiological indicators of tuberculosis in the Republic of Moldova during different periods and during the COVID-19 epidemics

BACKGROUND. The second milestone of the World Health Organization developed End TB Strategy to be met in 2025 was the declining of the incidence by 50 % and the absolute number of deaths by 75 % from 2015 levels. OBJECTIVE. To establish the dynamics of the main epidemiological indicators of tuberculosis in the Republic of Moldova during different periods including the period of COVID-19 pandemics in the frame of a prospective longitudinal study. MATERIALS AND METHODS. A prospective study, compared the statistical indicators of tuberculosis: global incidence, prevalence and mortality published in the informational system of monitoring and evaluation (SIME TB). RESULTS. The global incidence was declining from 2015 till 2020, and then increased from 56.68 per 100,000 population in 2020 to 66.34 per 100,000 population in 2024 with 17 % rise. The analysis of prevalence revealed significant changes between the periods 2015-2019 and 2020-2024: considering the overall frequency of all case-types, localization and microbiological state, it was established that in 2015-2019 the total tuberculosis cases decreased from 4,056 in 2015 to 3,186 in 2019, with the prevalence rate dropping from 100.55 to 79.31 per 100,000 population and in 2020-2024 the total tuberculosis cases further decreased from 2,220 in 2020 to 1,589 in 2024, with the prevalence rate falling from 71.54 to 54.45 per 100,000 population. Tuberculosis mortality for 2020 was 5.2 per 100,000 population (207 cases), in 2021 it was 6.5 per 100,000 population (199 cases) with 3.9 % decreased. In 2022 mortality rate was 6.7 per 100,000 population (207 cases), in 2023 – 3.1 per 100,000 population (125 cases) and in 2024 – 2.2 per 100,000 population (99 cases). CONCLUSIONS. Trends in tuberculosis prevalence and mortality indicate a general improvement in the control of this disease in Moldova over the past decades, with significant reductions in recent years. The increase with 17 % of the global incidence during the period of COVID-19 pandemic highlighted the challenges in tuberculosis control efforts in the country, underscoring the need for intensified interventions to reverse this trend and align with global reduction goals.