Tuberculosis incidence among medical workers in Moscow in 2015–2023

Introduction . The incidence of tuberculosis among health care workers belonging to a high-risk group is one of the most important indicators of the effectiveness of infection control measures. The aim was to study the dynamics of tuberculosis incidence among medical workers of medical organisations in the city of Moscow. Methodology . An analysis of the incidence of tuberculosis was conducted among 415 health care workers working in Moscow medical institutions for 2015–2023. We considered cases of tuberculosis among doctors, mid-level and junior medical personnel, in particular for two periods 2015–2019 and 2020–2023 to assess the effectiveness of measures taken for the early detection of tuberculosis among this population group. Results and discussion . From 30 to 56 cases of tuberculosis were registered annually among health care workers. The majority were women – 72.5%, people aged 20 to 40 years (53.4%), doctors (46.2%) or mid-level medical personnel (44.1%), permanent residents (60.7%); 85.1% were identified using active methods (screening). In 2020–2023 compared to the period 2015-2019, there was an improvement in the structure of clinical forms: the proportion of focal TB increased from 23.7 to 36.8% (p < 0.01), pulmonary TB with decay decreased from 22.9 to 10.5% (p < 0.01). When compared with the general population, limited forms of tuberculosis predominated in health care workers: the proportion of focal pulmonary tuberculosis was 40.6% compared with 11.9% in the general population, the proportion of disseminated tuberculosis was lower – 3.1% and 20.4% (p < 0.01). The incidence of tuberculosis among physicians (23.7 and 33.5 per 100,000) and nursing staff (24.1 and 16.2 per 100,000) in 2015–2019 and 2020–2023, respectively, was comparable to that of the adult population of Moscow during the same periods: 30.3 and 20.2 per 100 000, respectively, which confirmed the fulfilment of the WHO indicator target value reflecting the effectiveness of infection control. Conclusion . The study showed the high efficiency of anti-epidemic measures in medical institutions and demonstrated a significant improvement in their effectiveness during the study period.