Abstract
This study examines the epidemiological situation of tuberculosis (TB) in the regions of the Republic of Kazakhstan over the past seven years (2018-2024), which cover the before-, during- and after-COVID-19 periods, with a focus on the risks of its emergence and spread. The analysis revealed that while TB incidence is declining, mortality remains high in the before- and during-COVID-19 periods, indicating a general decline in population health. The concentration of TB incidence in relation to geographic location was mainly in the northern, western and southern regions. Before COVID-19, TB incidence reached 48.2 cases and mortality reached a maximum of 2.4 cases per 100,000 people. In 2024, the incidence and mortality of tuberculosis significantly decreased to 33.5 (30.5%) and 1.0 (58.3%), respectively, reflecting an improvement in health indicators in the post-pandemic period. In the after-COVID-19 period, in regions with high unemployment, the incidence was higher than in the before- and during-COVID-19 periods. Nevertheless, it is important that the trend in tuberculosis incidence shows positive improvement after the COVID-19 period. In addition, a comparative analysis of tuberculosis incidence trends in different age groups and social factor groups shows that the adult population remains the most vulnerable category among the general population. The above-listed factors, as well as our analysis of tuberculosis incidence, shows that TB incidence does not always correlate with the level of vaccination in different regions of Kazakhstan, indicating a multifactorial influence on the tuberculosis epidemic.