TERRITORIAL DIFFERENTIATION OF THE TUBERCULOSIS MORBIDITY AND MORTALITY TREND IN THE REPUBLIC OF CRIMEA

The research objective is to study the epidemiological situation on tuberculosis (TB) in the Republic of Crimea (RC) on the basis of territorial differentiation of TB morbidity and mortality trend during 2004-2015 with the use of multidimensional statistics method. We applied k-means clustering. The official statistics of TB morbidity and mortality for the period of 2004-2015 were provided by the "Crimean Republican Clinical Center of Phthisiology and Pulmonology". The grouping of Crimean territories on the TB morbidity and mortality rate trend into 4 clusters was optimal. In the analysis of the research finding the steady decline of the TB morbidity and mortality in all clusters was generally found. The most favourable situation and trend of rates studied occurred in Alushta, Armyansk and Sudak cities, Sovetsky and Chernomorsky districts (the 3rd cluster) where TB morbidity and mortality rate were below the regional mean values. The highest rates above Crimean mean values and unstable trend were identified in the Dzhankoy, Krasnogvardeysky and Krasnoperekopsky districts integrated into 4th cluster. In general for the studied period the trend of TB morbidity decline in cluster 1 (Kerch, Yalta, Yevpatoria and Feodosia cities, Belogorsky and Saky districts) was revealed. TB mortality trend corresponded to average Crimean one with low exceedance. In general the TB morbidity and mortality trend corresponded to the all-Crimean trend in lower values in cluster 2 (Simferopol city, Bakhchisarai, Kirovsky, Leninsky, Nizhnegorsky, Pervomaysky, Razdolnensky and Simferopol districts). The negative trend of TB morbidity and mortality in a number of RC territories can testify to problems in the work of Phthisiology service that required further analysis for correction management decisions.