Features of the epidemic situation on tuberculosis in the conditions of climate change in the Far North of the Republic of Sakha (Yakutia)

Abstract

Introduction: Global warming profoundly affects the Arctic's natural conditions, including permafrost thawing and greenhouse gas emissions, exacerbating the global warming effect. This impact is particularly evident in the Republic of Sakha (Yakutia), home to the world's thickest permafrost. Climate change also alters living conditions, leading to population concentration in major cities and improved medical care access. Accordingly, it is important to estimate TB incidence and mortality rates under climate change. Methods: Statistical data on annual average temperature, tuberculosis incidence, and mortality rates in the Republic of Sakha (Yakutia) over the past 40 years (1984–2023) were analyzed. Pearson's correlation coefficient assessed the relationship between air temperature and tuberculosis epidemiological indicators. A predictive model was developed through linear regression analysis, with significance set at p < 0.05. Results: Over the study period, the Republic of Sakha (Yakutia) experienced a 2.2°C increase in annual average air temperature (from -10.0°C to -7.8°C), with tuberculosis incidence decreasing by 60.5% (from 74.9 to 29.6 per 100,000 population) and tuberculosis mortality by 76.9% (from 12.6 to 2.9 per 100,000 population). Correlation analysis revealed weak negative correlations between tuberculosis incidence and annual average temperature (rxy -0.459845, p=0.006) and between tuberculosis mortality and annual average temperature (rxy = -0.427537, p=0.006).The linear regression analysis indicated that a 1°C rise in annual average temperature corresponded to a 6.068 decrease in tuberculosis incidence. The resulting regression model, with a correlation coefficient of rxy = 0.460, demonstrated a moderate degree of correlation on Chaddock's scale and was statistically significant (p = 0.003), explaining 21.1% of the observed variance in tuberculosis incidence. Additionally, a 1°C increase in annual average temperature was associated with a 1.001 decrease in tuberculosis mortality. The regression model, with a correlation coefficient of rxy = 0.428, also exhibited a moderate degree of correlation and statistical significance (p = 0.006), explaining 18.3% of tuberculosis mortality variance. Discussion: Elevated annual average temperatures are linked to reduced tuberculosis incidence and mortality, possibly due to improved living conditions and healthcare access in warmer climates. Conclusion: Over the last four decades, the Republic of Sakha (Yakutia) witnessed decreased tuberculosis incidence and mortality amidst climate warming attributed to global warming. However, factors like infrastructure development, innovative tuberculosis detection, diagnosis, and treatment methods, along with increased access to specialized medical tuberculosis care, should be considered in addressing the tuberculosis epidemiological situation in the region.