Incidence of tuberculosis in the Sakha Republic (Yakutia), broken down by socioeconomic zone, and time period based on the level of IT-solution implementation

Background . Tuberculosis (TB) remains a priority public health problem, including in the Far North regions with low population density and insufficient transport infrastructure. This necessitates the introduction of digital technologies to increase access to tuberculosis care, improve diagnostics, epidemiological monitoring, and control of the disease, as exemplified by the Republic of Sakha (Yakutia). The aim . To analyze the dynamics of TB incidence in the socio-economic zones of the Republic of Sakha (Yakutia) at the stages of introducing information technologies into the activities of the anti-tuberculosis service. Methods . A retrospective epidemiological study was conducted, the incidence of tuberculosis and the main clinical and epidemiological indicators were analyzed in five zones of the Republic of Sakha (Yakutia). Official statistical data were retrospectively analyzed for 3 periods: 1. Traditional workflow practices (2014-2016); 2. Implementation of digital solutions (2017-2019); 3. Widescale use of digital solutions (2020-2024). Results . By 2024, total incidence had declined by a factor of 2.5 (from 65.0 0 / 0000 to 26.3 0 / 0000 per 100 000), most prominently in Arctic zone (from 76.8 0 / 0000 to 18.7 0 / 0000 per 100 000) and the Rural zone (from 72.0 0 / 0000 to 15.0 0 / 0000 per 100,000), while the smallest decline was in Yakutsk (from 88.8 0 / 0000 to 42.00 0 / 0000 per 100,000). Alongside the general decrease in TB incidence, there was a trend toward an increase in the proportion of multidrug-resistant (MDR) cases among newly diagnosed TB patients across the republic, reaching 41.3% primary MDR by 2020-2024, with the highest rates in urbanized and industrialized zones. Additionally, a structural shift in the clinical picture was recorded in Sakha Republic (Yakutia), characterized by a significant rise in the share of destructive forms of pulmonary TB among newly diagnosed TB cases of the respiratory organs. Conclusions . The study demonstrated changes in the epidemic process of TB during the digitalization period: a steady decline in incidence, likely due to improved detection, against a backdrop of increasing MDR cases, which may be associated with advancements in diagnosing complex forms of the disease and a more complicated epidemiological picture for TB.