Analysis of the impact of crises tuberculosis incidence in Ukraine amid pandemics and war

Ukraine has a historically high burden of tuberculosis (TB). As a result of many years of the healthcare system’s reformation, the epidemiological situation has improved. However, under the influence of the COVID-19 pandemic and the illegal invasion by Russia, fluctuations in incidence occur. Through a retrospective, observational analysis using data from the Public Health Center of the Ministry of Health of Ukraine, this study tracked the incidence of TB and multidrug-resistant tuberculosis (MDR TB) and highlights changes caused by crises. The region that maintained a consistently high level of TB and MDR TB throughout the entire study period was Southeastern Ukraine. Data analysis showed a significantly increased TB incidence in Central Ukraine in 2022–2023 (62.75 per 100,000 population) versus 36.55 per 100,000 population in the 2013–2019 period. In Eastern Ukraine, TB incidence decreased markedly (14.95 per 100,000 population) after the beginning of the war in 2022 compared with the pre-COVID-19 pandemic 2013–2019 period (50.36 per 100,000 population). These results indicate a changing pattern of TB incidence throughout Ukraine during the conflict, with lower rates in conflict-affected areas and higher rates in host regions. This reflects the importance of strengthening TB surveillance and control strategies adapted to areas experiencing population influx.