In Russia, with increase in life standard and following it improvement in the TB epidemic situation, socio-demographic, health care managing, climatic and environmental TB risk factors, such as population density, intensity of social contacts, availability of medical care, seasonal climate changes, environmental problems, that affect the quality of public health are becoming the leading ones. Meanwhile, the severity of certain TB risk factors in Russian regions depending on population density has not been studied yet.
In our presentation we are aimed to provide a comparative analysis of leading TB risk factors in regions with low and high population density.
The study was ecological one with sociological, cluster-quota research method, with a sample formed by respondents and a face-to-face distribution questionnaire of 2500 people, of which 1497 were from North Ossetia-Alania Republic with a high population density, 1003 - from the Republic of Karelia with a low population density. The reliability of differences was assessed by the value of exact criterion Fisher using a contingency table.
We obtained the following results: in the Republic of Karelia, compared with North Ossetia-Alania Republic, despite a higher gross regional product (527.8 thousand rubles vs. 293.4 thousand rubles, p<0.000), social and behavioral TB risk factors were significantly higher: fewer respondents with high education (18.4% vs. 33.6%, p<0.000), more divorced persons (18.7% vs. 26.9%, p<0.022), living in apartment buildings (65.0% vs. 39.5%, p<0.000), more hired and seasonal workers, unemployed, pensioners due to age and disability (55.0% vs. 32.3%, p<0.000), more alcohol abusers (67.4% vs. 34.3%, p<0.000), “heavy” smokers (20.8% vs. 7.2%, p<0.000), more people with chronic diseases (43.7% vs. 32.1%, p<0.02); also there are problems associated with accessibility to medical care: municipal policlinics are less accessible (42.7% vs. 85.6%, p<0.000), the distant location of medical facilities (21.4% vs. 2.7%, p<0.000) , lack of transport links (15.7% vs. 8.5%, p<0.000), poor roads (5.9% vs. 16.9%, p<0.000) and lack of medical specialists (60.9% vs. 16, 8%, p<0.000) more often noted. On the other hand in North Ossetia-Alania Republic, respondents had more frequent social contact with TB patients than in the Republic of Karelia (66.9% vs. 34.8%, p<0.000).
The study results allow us to conclude that the leading TB factors in regions with high population density are epidemiological ones; in regions with low population density, social, behavioral and accessibility to medical care factors remain relevant, which should be taken into account when developing measures to effective manage the epidemic process.