Analysis of long-term dynamics of morbidity by the method of complex assessment at different territorial levels

Evgeniy Savilov, Polina Khromova, Svetlana Shugaeva, S. Oryshchak, Vyacheslav Sinkov, Oleg Ogarkov
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Abstract

Background: A comparative epidemiological analysis of the primary incidence of tuberculosis was carried out using its standard approach with a generalized indicator that takes into account the main statistical criteria for incidence. The "sensitivity" of the method may vary depending on the population in the analyzed territories.Aims: The aim of the study is a comparative assessment of the standard epidemiological approach and the method of integral assessment in the primary analysis of incidence at different territorial levels on the example of the epidemic process of tuberculosis.Materials and methods: A retrospective study of the dynamics of the incidence of tuberculosis in the total population at the levels of the federal districts (FD) of Russia, subjects of the Siberian Federal District (SFD) and urban municipalities of the Irkutsk Region (a structural unit of the SFD) for the period 20052019) was carried out. Based on the obtained integral indicators, a generalized visibility coefficient was calculated. Results: A statistically significant decrease in the incidence of TB was established at the level of all federal districts and subjects of the SFD. When assessing the average long-term incidence rates, the maximum discrepancy between ranking places was inversely proportional to the size of the studied territories: 1.5 positions - at the level of the FD, 2 positions - at the level of regional formations and 5 positions - at the level of urban settlements.Conclusions: The integral assessment method can be used in the primary analysis of morbidity in all types of infectious and non-infectious pathologies. The generalized morbidity criterion expands the informative possibilities of the standard indicator, contributes to the substantiation of risk areas already at the initial stages of epidemiological analysis, and responds more sensitively to changes in the epidemiological situation in relatively small areas.
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用综合评估方法分析不同地区发病率的长期动态变化
背景:对结核病的主要发病率进行了流行病学比较分析,采用的是标准方法和考虑到发病率主要 统计标准的综合指标。该方法的 "灵敏度 "可能因所分析地区的人口而异。研究目的:该研究的目的是以结核病流行过程为例,对标准流行病学方法和综合评估方法在不同地区一级的发病率初步分析中进行比较评估:对 2005 年至 2009 年期间俄罗斯各联邦区、西伯利亚联邦区和伊尔库茨克州(西伯利亚联邦区的一个结构单元)城市总人口的结核病发病率动态进行了回顾性研究。根据所获得的综合指标,计算出了广义能见度系数。结果显示从统计学角度看,所有联邦区和联邦直辖区的结核病发病率都有明显下降。在评估长期平均发病率时,排名之间的最大差异与所研究地区的面积成反比:1.5 位--在联邦区一级,2 位--在地区组织一级,5 位--在城市住区一级:综合评估法可用于对各类传染性和非传染性疾病的发病率进行初步分析。通用发病率标准扩大了标准指标的信息量,有助于在流行病学分析的初始阶段就确定风险地区,并对相对较小地区的流行病学形势变化做出更敏感的反应。
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