Development and application experience of the clinical and organizational management algorithm for tuberculosis medical care at the regional level

Cover Page

Cite item


Relevance. The high incidence, prevalence and mortality in tuberculosis determines the relevance of improving clinical and organizational processes in terms of algorithmization. The aim of the study was to develop and evaluate the effectiveness of the clinical and organizational management algorithm for tuberculosis medical care at the regional level. Materials and Methods. The object of the study (2007-2021) were the tuberculosis medical care system of the Sverdlovsk region, Russian Federation. The scientific and methodological bases were Department of Health Organization, Drug Supply, Medical Technologies and Hygiene of the Peoples’ Friendship University of Russia topic SRW № 214791-3-000. The development of the algorithm was carried out on the basis of a scientifically proven universal clinical management system. The epidemiological tuberculosis author data and of Rosstat in the Sverdlovsk region for 2007-2020 were used - general and structural morbidity, prevalence, mortality, as well as the number of 3, 4 and 6 groups of dispensary registration of patients. The efficiency of the algorithm was evaluated by the dynamics of the complex of epidemiological indicators of tuberculosis. Research methods were applied: content analysis, analytical, statistical, comparative, expert. Significance was assessed using the t-White test. Differences in the compared parameters were considered significant at p<0.05. Results and Discussion. The effectiveness of the developed algorithm for managing regional tuberculosis medical care, including the components of needs analysis, systematization, automation and telecommunications, interdisciplinary integration, resource provision and performance evaluation, was confirmed by a significant decrease in the Sverdlovsk region for the period 2007-2020 general incidence by 2.05 times (from 119.9 to 51.7 per 100 thousand of the population), the incidence of children 0-14 years old by 1.48 times (from 18.7 to 12.6 per 100 thousand children of the corresponding age), prevalence in the population by 1.8 times (from 258.6 to 143 per 100 thousand of the population) and mortality from tuberculosis by 2.675 times (from 21.4 to 8.02 per 100 thousand of the population) (p<0.001). The COVID-19 pandemic (2020-2021) did not worsen the epidemiological situation for tuberculosis in the region. In 2020, an active form of tuberculosis was detected in 2201 people, which is 16 % less than in 2019 (p<0.05). The prevalence of epidemiologically dangerous bacillary forms of the disease for the period 2019-2020 decreased by 15.4 %, from 73.2 to 61.9 per 100 thousand population (p<0.05). Conclusion. Clinical and organizational management of tuberculosis medical care based on the algorithmization of scientifically evidence processes increases the effectiveness of therapeutic and preventive measures and the social and epidemiological well-being of the population.

About the authors

Andrey A. Kostin

Peoples’ Friendship University of Russia

ORCID iD: 0000-0002-0792-6012
Moscow, Russian Federation

Aleksey Yu. Abramov

Peoples’ Friendship University of Russia

ORCID iD: 0000-0001-7178-1260
Moscow, Russian Federation

Andrey I. Tsvetkov

Ural State Medical University of the Ministry of Health of Russia

ORCID iD: 0000-0002-8751-6872
Yekaterinburg, Russian Federation

Dmitry I. Kicha

Peoples’ Friendship University of Russia

Author for correspondence.
ORCID iD: 0000-0001-6529-372X
Moscow, Russian Federation

Oleg V. Rukodaynyy

Peoples’ Friendship University of Russia

ORCID iD: 0000-0001-9134-7189
Moscow, Russian Federation

Roman S. Goloshchapov-Aksenov

Peoples’ Friendship University of Russia

ORCID iD: 0000-0003-3085-7729
Moscow, Russian Federation


  1. Vasilyeva I, Belilovsky E, Borisov S, Sterlikov S. Incidence, mortality and prevalence as indicators of the burden of tuberculosis in WHO regions, countries of the world and in the Russian Federation. Part 1. Incidence and prevalence of tuberculosis. Tuberculosis and lung diseases.2017;95(6):9-21. (In Russian)
  2. Erokhin V. Tuberculosis in Russia. Socially significant diseases in the Russian Federation. Under rel. L.A. Bokeria and I.N. Stupakov. M.: NTSSSH im. A.N. Bakuleva RAMS.2006:263-266 (In Russian).
  3. Naigovzina N, Filatov V, Erokhin V, Punga V. Tuberculosis in the Russian Federation. Epidemiology and infectious diseases.2009;3:4-11 (In Russian).
  4. Krivonos O, Mikhailova L, Skachkova E, Kormacheva E, Son I, Sterlikov S, Perelman M, Bogorodskaya E, Frolova O, Shilova M, Popov S, Aksenova V, Borisov S, Punga V, Galkin V, Mushkin A, Baryshev S, Odintsov V, Safonova S, Belilovsky E, Danilova I, Pashkevich D, Yurasova E, Malakhov V, Shulgina M, Zaikin E. Mortality rate of patients with tuberculosis in the Russian Federation. Tuberculosis in the Russian Federation, 2009. An analytical review of the TB statistical indicators used in the Russian Federation. Moscow., 2011; 208p.
  5. World Health Organization. Global tuberculosis report 2019. Geneva, Switzerland: World Health Organization; 2019. 283p. WHO REFERENCE NUMBER: WHO/CDS/TB/2019.15 icon.
  6. World Health Organization. Systematic screening for active tuberculosis. principles and recommendations. World Health Organization Document; 2013. (WHO/HTM/TB/2013.04:1-133).
  7. Khovanov A, Nechaev V, Krylov V, Vasiliev V, Skvortsov A. Object-relational approach in modeling the dispensary registration of patients with tuberculosis. Problems of tuberculosis and lung diseases. 2007;4:10-13. (In Russian)
  8. Shchepin O, Starodubov V, Lindenbraten A. Methodological bases and mechanisms for ensuring the quality of medical care. M.: Medicine, 2002. 146p. (In Russian)
  9. Kicha D, Abramov A, Rukodaynyy O, Makaryan A, Goloshchapov-Aksenov R. Evidence-Based Health Systems Effectiveness. Modern problems of public health and medical statistics. 2019;5:87-88. (In Russian)
  10. Skachkova E, Matinyan N, Shestakov M, Kucheryavaya D, Vladimirov S. Assessment of the influence of social factors on the incidence of tuberculosis. Characteristics of the socio-professional composition of newly diagnosed patients with tuberculosis. Problems of health care management. 2009; 3(46): 34-39. (In Russia)
  11. Skvortsov A, Maslennikov B, Vasiliev V, Khovanov A. Computer simulation in managing the epidemic situation of tuberculosis in the Russian region. Bulletin of the Tver State Technical University. Tver: TSTU. 2009; issue 14:63-68. (In Russian)
  12. Eitmont N, Tsvetkov A, Kozhekina N, Fomenko N, Boyarkina V, Senin A, Byzov N. The incidence of tuberculosis in the Sverdlovsk region. Ural Medical Journal.2013;2(107):14-17. (In Russian)
  13. Abramov A, Goloshchapov-Aksenov R, Kicha D, Rukodaynyy O. Organizational and technological algorithm of primary specialized health care at cardiovascular diseases. Kazan medical journal.2020;101(3):394-402.

Copyright (c) 2022 Kostin A.A., Abramov A.Y., Tsvetkov A.I., Kicha D.I., Rukodaynyy O.V., Goloshchapov-Aksenov R.S.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies