Особливості сучасного туберкульозу у медичних працівників

Objective — to study trends and characteristics of the patterns of tuberculosis (TB) incidence among medical workers of Vinnytsya region during 2007—2023. Materials and methods. The primary medical records (cards of inpatients and outpatients, report forms) of 207 medical workers of the Vinnytsya region who were diagnosed with TB from 2007 to 2023 was analyzed. The study included only employees of healthcare institutions of Vinnytsya who provided medical services to patients (doctors, middle and junior medical staff), excluding the staff of the technical sector of medical institutions. Based on the data of the official documentation, the peculiarities of the incidence and clinical course of TB among medical workers of the general treatment network and anti-tuberculosis institutions were studied. Results and discussion. According to the results of the analysis, from 2007 to 2023, 207 cases of TB were observed among medical workers in the Vinnytsya region, which accounted for 1.6 % of all TB cases in the region. In general, during the 17-year study period, the incidence of TB among medical workers in the Vinnytsya region was lower than the incidence of the population (48.7 per 100 000 medical workers versus 58.9 per 100,000 population of the region, p < 0.01). The incidence among medical workers in anti-tuberculosis facilities in general amounted to 535.5 per 100,000 medical workers in anti-tuberculosis facilities. In general healthcare facilities, the incidence of middle medical personnel was 42.3 per 100,000 people, junior medical staff — 46.9 per 100.000 people, and doctors — 42.4 per 100,000 doctors, and among healthcare workers of anti-tuberculosis facilities — 766, 525 and 113 per 100,000 people, respecti­vely. Pulmonary forms of the disease were diagnosed in 173 people (83.6 %), and extrapulmonary forms were diagnosed in 34 medical workers (16.4 %). Among all cases of pulmonary TB, focal forms were found in 39 medical workers (22.5 %), infiltrative forms in 57 medical workers (32.9 %), and disseminated forms in 67 medical workers (38.7 %), and in 8 people (5.9 %) were diagnosed with pulmonary tuberculomas. The number of TB relapses was 36 (17.4 %), and the incidence rate was 8.1 per 100,000 medical workers. Conclusions. From 2007 to 2023, the incidence of TB among medical workers in the Vinnytsya region was lower than in the general population (46.8 per 100,000 medical workers versus 56.8 per 100,000 population of the region), while among healthcare workers in TB facilities, it was 11 times higher than among those in general healthcare facilities (535.5 and 46.8 per 100,000 medical workers, respectively). The highest number of TB cases among medical workers in general healthcare facilities was registered in junior medical staff, whereas in TB facilities, it was most common among middle medical staff. The incidence of extrapulmonary TB among medical workers was higher than in the general population — 7.6 and 5.1 per 100,000 people, respectively. Among pulmonary forms of TB in medical workers, limited forms predominated (61.3 %), and disease relapses were less frequent compared to the general population (the incidence rate was 8.1 and 10.5 per 100,000 people, respectively).