{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:26:31Z","timestamp":1792301191248,"version":"4.4.0"},"reference-count":77,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Khoja Akhmet Yassawi International Kazakh-Turkish University from the Committee of Science of the Ministry of Science and Higher Education of the Republic of Kazakhstan","award":["BR24992814"],"award-info":[{"award-number":["BR24992814"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: In 2023, tuberculosis (TB) caused 1.25 million deaths globally, remaining a leading infectious killer. Central Asia and Southern Caucasus face high TB burdens, particularly Mongolia. This review synthesizes TB prevalence data and diagnostic capabilities in these regions to support public health strategies. Methods: This systematic review aimed to synthesize current data on TB prevalence in Central Asia, Southern Caucasus, and Mongolia to support public health strategies and research priorities. A comprehensive search of PubMed and Google Scholar was conducted for English-language articles published up to 2023. Studies were assessed using a modified Newcastle\u2013Ottawa Scale. Nine studies met the inclusion criteria, covering Kazakhstan, Kyrgyzstan, Uzbekistan, Tajikistan, Turkmenistan, Mongolia, Georgia, Armenia, and Azerbaijan. Results: TB incidence ranged from 67 per 100,000 in Kazakhstan to 190 per 100,000 in Kyrgyzstan, with the highest prevalence of 68.5% in Mongolia. TB affected men more frequently (65.3%), and the key risk factors included HIV (30.5%), comorbidities, and undernutrition. Diagnostic performance varied significantly (microscopy sensitivity, 45\u201365%; GeneXpert MTB\/RIF, 89\u201396% sensitivity and 98% specificity for rifampicin resistance). Diagnostic turnaround times ranged from hours (molecular) to weeks (conventional). Only 58% of TB facilities had GeneXpert technology, with urban\u2013rural disparities in diagnostic access. Drug-resistant TB imposed a significant economic burden, with treatment costs ranging from USD 106 to USD 3125. Conclusions: Strengthening surveillance, improving data collection, and conducting longitudinal studies are essential for designing effective TB control strategies in these regions. Significant diagnostic gaps persist across these regions, especially with regard to drug-resistant strains. Point-of-care molecular diagnostics, improved algorithms, and expanded laboratory training show promise. Future research should focus on rapid biomarker-based diagnostics, field-deployable technologies for settings with limited resources, and AI integration to enhance diagnostic accuracy and efficiency.<\/jats:p>","DOI":"10.3390\/diagnostics15182314","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T07:52:28Z","timestamp":1757663548000},"page":"2314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of Tuberculosis in Central Asia and Southern Caucasus: A Systematic Literature Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2684-7595","authenticated-orcid":false,"given":"Malika","family":"Idayat","sequence":"first","affiliation":[{"name":"The Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan"},{"name":"The Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan 161200, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"von der Lippe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2260-6588","authenticated-orcid":false,"given":"Nailya","family":"Kozhekenova","sequence":"additional","affiliation":[{"name":"The Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan"},{"name":"The Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan 161200, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oyunzul","family":"Amartsengel","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Mongolian National University of Medical Science, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamila","family":"Akhmetova","sequence":"additional","affiliation":[{"name":"Department of Public Health and Management, NJSC \u00abAstana Medical University\u00bb, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5655-5465","authenticated-orcid":false,"given":"Ainash","family":"Oshibayeva","sequence":"additional","affiliation":[{"name":"The Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan 161200, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-1971","authenticated-orcid":false,"given":"Zhansaya","family":"Nurgaliyeva","sequence":"additional","affiliation":[{"name":"The Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan"},{"name":"The Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan 161200, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1400-8436","authenticated-orcid":false,"given":"Natalya","family":"Glushkova","sequence":"additional","affiliation":[{"name":"The Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan"},{"name":"The Faculty of Postgraduate Medical Education, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkistan 161200, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025). Tuberculosis [Internet], World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tuberculosis."},{"key":"ref_2","unstructured":"European Centre for Disease Prevention and Control, and World Health Organization Regional Office for Europe (2019). Tuberculosis Surveillance and Monitoring in Europe 2019: 2017 Data, WHO Regional Office for Europe. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/tuberculosis-surveillance-and-monitoring-europe-2019."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.21292\/2075-1230-2017-95-7-8-16","article-title":"Incidence, mortality and prevalence as indicators of tuberculosis burden in WHO regions, countries of the world and the Russian Federation. Part 2. Tuberculosis mortality","volume":"95","author":"Vasilyeva","year":"2017","journal-title":"Tuberc. Lung Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/S1473-3099(21)00449-7","article-title":"Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990\u20132019: Results from the Global Burden of Disease Study 2019","volume":"22","author":"Ledesma","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","unstructured":"World Health Organization (2025, August 31). Global Tuberculosis Report. Available online: https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2024."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e060906","DOI":"10.1136\/bmjopen-2022-060906","article-title":"Prevalence and risks of tuberculosis multimorbidity in low-income and middle-income countries: A meta-review","volume":"12","author":"Jarde","year":"2022","journal-title":"BMJ Open"},{"key":"ref_7","unstructured":"World Health Organization (2025, August 31). Global Tuberculosis Report. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/274453\/9789241565646-eng.pdf."},{"key":"ref_8","unstructured":"Skrahin, A. (2025, March 31). Available online: http:\/\/qims.amegroups.com\/article\/view\/11254\/12011."},{"key":"ref_9","unstructured":"(2025, March 31). WHO-USAID Project to End Drug-Resistant Tuberculosis in Central Asia Concludes. Available online: https:\/\/www.who.int\/europe\/news-room\/20-10-2023-who-usaid-project-to-end-drug-resistant-tuberculosis-in-central-asia-concludes."},{"key":"ref_10","unstructured":"European Centre for Disease Prevention and Control, and World Health Organization (2025). Tuberculosis Surveillance and Monitoring in Europe 2025\u20142023 Data, Publications Office of the European Union. Available online: https:\/\/data.europa.eu\/doi\/10.2900\/2650058."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S1473-3099(19)30568-7","article-title":"Drug-resistant tuberculosis in eastern Europe and central Asia: A time-series analysis of routine surveillance data","volume":"20","author":"Dadu","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_12","unstructured":"World Health Organization (2024). TB Data Portal: Country Profiles, WHO. Available online: https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/."},{"key":"ref_13","unstructured":"(2025, March 31). Mongolia-Tuberculosis Death Rate (per 100,000 People)\u20142025 Data 2026 Forecast 2000\u20132023 Historical. Available online: https:\/\/tradingeconomics.com\/mongolia\/tuberculosis-death-rate-per-100000-people-wb-data.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e061229","DOI":"10.1136\/bmjopen-2022-061229","article-title":"Assessing the quality of tuberculosis care using routine surveillance data: A process evaluation employing the Zero TB Indicator Framework in Mongolia","volume":"12","author":"Saranjav","year":"2022","journal-title":"BMJ Open"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s00586-012-2334-8","article-title":"Factors that influence current tuberculosis epidemiology","volume":"22","author":"Millet","year":"2012","journal-title":"Eur. Spine J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Winetsky, D.E., Almukhamedov, O., Pulatov, D., Vezhnina, N., Dooronbekova, A., Zhussupov, B., and Mokrousov, I. (2014). Prevalence, Risk Factors and Social Context of Active Pulmonary Tuberculosis among Prison Inmates in Tajikistan. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0086046"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"94S","DOI":"10.3855\/jidc.11952","article-title":"Tuberculosis in key populations in Tajikistan-a snapshot in 2017","volume":"14","author":"Tilloeva","year":"2020","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_18","unstructured":"World Health Organization (2025, April 30). Global Tuberculosis Report. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/329368\/9789241565714-eng.pdf."},{"key":"ref_19","unstructured":"World Health Organization (2021). Impact of the COVID-19 Pandemic on TB Detection and Mortality in 2020 [Internet], World Health Organization. Available online: https:\/\/www.who.int\/publications\/m\/item\/impact-of-the-COVID-19-pandemic-on-tb-detection-and-mortality-in-2020."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Davies, M.-A. (2020). HIV and risk of COVID-19 death: A population cohort study from the Western Cape Province, South Africa. medRxiv.","DOI":"10.1101\/2020.07.02.20145185"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Glaziou, P. (2020). Predicted impact of the COVID-19 pandemic on global tuberculosis deaths in 2020. medRxiv.","DOI":"10.1101\/2020.04.28.20079582"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"00622","DOI":"10.1183\/23120541.00622-2021","article-title":"Programme costs of longer and shorter tuberculosis drug regimens and drug import: A modelling study for Karakalpakstan, Uzbekistan","volume":"8","author":"Kohler","year":"2022","journal-title":"ERJ Open Res."},{"key":"ref_23","unstructured":"World Health Organization (2025, April 30). Global Tuberculosis Report. Available online: https:\/\/www.iom.int\/sites\/g\/files\/tmzbdl486\/files\/documents\/2023-03\/Global-TB-Report-2021.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/S0140-6736(20)30608-5","article-title":"Health sector spending and spending on HIV\/AIDS, tuberculosis, and malaria, and development assistance for health: Progress towards Sustainable Development Goal 3","volume":"396","author":"Micah","year":"2020","journal-title":"Lancet"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Tabyshova, A., Emilov, B., Postma, M.J., Chavannes, N.H., Sooronbaev, T., and van Boven, J.F.M. (2020). Prevalence and Economic Burden of Respiratory Diseases in Central Asia and Russia: A Systematic Review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207483"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3201\/eid1005.030718","article-title":"Multidrug-resistant Tuberculosis in Central Asia","volume":"10","author":"Cox","year":"2004","journal-title":"Emerg. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.5588\/pha.14.0049","article-title":"First national survey of anti-tuberculosis drug resistance in Azerbaijan and risk factors analysis","volume":"4","author":"Alikhanova","year":"2014","journal-title":"Public Health Action"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1620\/tjem.2022.J034","article-title":"Childhood Tuberculosis in Mongolia: Trends and Estimates, 2010\u20132030","volume":"257","author":"Zanaa","year":"2022","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e16071","DOI":"10.1097\/MD.0000000000016071","article-title":"A retrospective analysis of treatment outcomes of drug-susceptible TB in Kazakhstan, 2013\u20132016","volume":"98","author":"Sadykova","year":"2019","journal-title":"Medicine"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Arnold, M., Beran, D., Haghparast-Bidgoli, H., Batura, N., Akkazieva, B., Abdraimova, A., and Skordis-Worrall, J. (2016). Coping with the economic burden of Diabetes, TB and co-prevalence: Evidence from Bishkek, Kyrgyzstan. BMC Health Serv. Res., 16.","DOI":"10.1186\/s12913-016-1369-7"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5365\/wpsar.2023.14.1.931","article-title":"Epidemiology of tuberculosis in Mongolia: Analysis of surveillance data, 2015\u20132019","volume":"14","author":"Boldoo","year":"2023","journal-title":"West. Pac. Surveill. Response"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gadoev, J., Asadov, D., Harries, A.D., Parpieva, N., Tayler-Smith, K., Isaakidis, P., Ali, E., Hinderaker, S.G., Ogtay, G., and Ramsay, A. (2017). Recurrent tuberculosis and associated factors: A five-year countrywide study in Uzbekistan. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0176473"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Trubnikov, A., Hovhannesyan, A., Akopyan, K., Ciobanu, A., Sadirova, D., Kalandarova, L., Parpieva, N., and Gadoev, J. (2021). Effectiveness and Safety of a Shorter Treatment Regimen in a Setting with a High Burden of Multidrug-Resistant Tuberculosis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18084121"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Bastard, M., Sanchez-Padilla, E., du Cros, P., Khamraev, A.K., Parpieva, N., Tillyashaykov, M., Hayrapetyan, A., Kimenye, K., Khurkhumal, S., and Dlamini, T. (2018). Outcomes of HIV-infected versus HIV-non-infected patients treated for drug-resistance tuberculosis: Multicenter cohort study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193491"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"20743","DOI":"10.2807\/1560-7917.ES2014.19.11.20743","article-title":"Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011","volume":"19","author":"Jenkins","year":"2014","journal-title":"Euro Surveill."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hof, S.v.D., Collins, D., Hafidz, F., Beyene, D., Tursynbayeva, A., and Tiemersma, E. (2016). The socioeconomic impact of multidrug resistant tuberculosis on patients: Results from Ethiopia, Indonesia and Kazakhstan. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1802-x"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Rechel, B., and McKee, M. (2007). The effects of dictatorship on health: The case of Turkmenistan. BMC Med., 5.","DOI":"10.1186\/1741-7015-5-21"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.1016\/j.drugalcdep.2013.07.012","article-title":"Tuberculosis, drug use and HIV infection in Central Asia: An urgent need for attention","volume":"132","author":"Schluger","year":"2013","journal-title":"Drug Alcohol. Depend."},{"key":"ref_39","unstructured":"World Health Organization (2025, April 30). Global Tuberculosis Report. Available online: https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2023."},{"key":"ref_40","unstructured":"Stop TB Partnership (2025, April 30). Home [Internet]. Geneva: Stop TB Partnership. Available online: https:\/\/www.stoptb.org\/."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa0907847","article-title":"Rapid Molecular Detection of Tuberculosis and Rifampin Resistance","volume":"363","author":"Boehme","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e074208","DOI":"10.1136\/bmjopen-2023-074208","article-title":"Epidemiology of tuberculosis in Kazakhstan: Data from the Unified National Electronic Healthcare System 2014\u20132019","volume":"13","author":"Sakko","year":"2023","journal-title":"BMJ Open"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Jing, C., Zheng, H., Wang, X., Wang, Y., Zhao, Y., Liu, S., Zhao, J., and Du, Q. (2023). Disease burden of tuberculosis and post-tuberculosis in Inner Mongolia, China, 2016-2018-based on the disease burden of post-TB caused by COPD. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08375-w"},{"key":"ref_44","unstructured":"International Organization for Migration (IOM) (2015). Regional Migrant Health Survey on Tuberculosis and HIV and Health Service Response for Migrants in Armenia, Azerbaijan and Georgia, IOM. Available online: https:\/\/reliefweb.int\/report\/world\/regional-migrant-health-survey-tuberculosis-and-hiv-and-health-service-response."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Terlikbayeva, A., Hermosilla, S., Galea, S., Schluger, N., Yegeubayeva, S., Abildayev, T., Muminov, T., Akiyanova, F., Bartkowiak, L., and Zhumadilov, Z. (2012). Tuberculosis in Kazakhstan: Analysis of risk determinants in national surveillance data. BMC Infect. Dis., 12.","DOI":"10.1186\/1471-2334-12-262"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Karuniawati, A., Burhan, E., Koendhori, E.B., Sari, D., Haryanto, B., Nuryastuti, T., Gayatri, A.A.A.Y., Bahrun, U., Kusumawati, R.L., and Sugiyono, R.I. (2023). Performance of Xpert MTB\/RIF and sputum microscopy compared to sputum culture for diagnosis of tuberculosis in seven hospitals in Indonesia. Front. Med., 9.","DOI":"10.3389\/fmed.2022.909198"},{"key":"ref_47","first-page":"41","article-title":"Tuberculosis and rifampicin resistance among migrants in Kyrgyzstan: Detection by a new diagnostic test","volume":"77","author":"Barmankulova","year":"2015","journal-title":"Nagoya J. Med. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Yuldashev, S., Parpieva, N., Alimov, S., Turaev, L., Safaev, K., Dumchev, K., Gadoev, J., Korotych, O., and Harries, A.D. (2021). Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012\u20132019: Are We on the Right Track?. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094685"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1016\/j.jiph.2023.10.009","article-title":"Prevalence and factors associated with tuberculosis infection in India","volume":"16","author":"Selvaraju","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1017\/S0950268818001450","article-title":"Sex and age differences in Mycobacterium tuberculosis infection in Brazil","volume":"146","author":"Fernandes","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Seifert, M., Aung, H.T., Besler, N., Harris, V., Mar, T.T., Colman, R.E., Rodwell, T.C., and Aung, S.T. (2021). Age and sex distribution of Mycobacterium tuberculosis infection and rifampicin resistance in Myanmar as detected by Xpert MTB\/RIF. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06296-0"},{"key":"ref_52","first-page":"2261","article-title":"Mortality Rates after Tuberculosis Treatment, Georgia, USA, 2008\u20132019-Volume 30, Number 11\u2014November 2024-Emerging Infectious Diseases journal-CDC","volume":"30","author":"Gorvetzian","year":"2024","journal-title":"Emerg. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lv, H., Zhang, X., Zhang, X., Bai, J., You, S., Li, X., Li, S., Wang, Y., Zhang, W., and Xu, Y. (2024). Global prevalence and burden of multidrug-resistant tuberculosis from 1990 to 2019. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-09079-5"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Min, J., Park, J.S., Kim, H.W., Ko, Y., Oh, J.Y., Jeong, Y.-J., Na, J.O., Kwon, S.-J., Choe, K.H., and Lee, W.-Y. (2023). Differential effects of sex on tuberculosis location and severity across the lifespan. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-33245-5"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Wang, X., Yin, S., Li, Y., Wang, W., Du, M., Guo, W., Xue, M., Wu, J., Liang, D., and Wang, R. (2019). Spatiotemporal epidemiology of, and factors associated with, the tuberculosis prevalence in northern China, 2010\u20132014. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3910-x"},{"key":"ref_56","first-page":"1","article-title":"Spatial Analysis of Childhood Tuberculosis and Social Determinants in Bandar Lampung","volume":"202","year":"2020","journal-title":"E3S Web Conf."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Smith, J.P., Oeltmann, J.E., Hill, A.N., Tobias, J.L., Boyd, R., Click, E.S., Finlay, A., Mondongo, C., Zetola, N.M., and Moonan, P.K. (2022). Characterizing tuberculosis transmission dynamics in high-burden urban and rural settings. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-10488-2"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"20609","DOI":"10.2807\/1560-7917.ES2013.18.42.20609","article-title":"Multidrug-resistant tuberculosis in Uzbekistan: Results of a nationwide survey, 2010 to 2011","volume":"18","author":"Ulmasova","year":"2013","journal-title":"Eurosurveillance"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ay\u00e9, R., Wyss, K., Abdualimova, H., and Saidaliev, S. (2010). Illness costs to households are a key barrier to access diagnostic and treatment services for tuberculosis in Tajikistan. BMC Res. Notes, 3.","DOI":"10.1186\/1756-0500-3-340"},{"key":"ref_60","unstructured":"(2025, April 30). Exploring Catastrophic Household Costs for Tuberculosis Treatment. Available online: https:\/\/tdr.who.int\/newsroom\/news\/item\/29-06-2023-exploring-catastrophic-household-costs-for-tuberculosis-treatment."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1183\/09031936.00193413","article-title":"Financial burden for tuberculosis patients in low- and middle-income countries: A systematic review","volume":"43","author":"Tanimura","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_62","unstructured":"(2025, June 15). Eliminating Tuberculosis (TB) in Central Asia|Abt Global. Available online: https:\/\/www.abtglobal.com\/projects\/eliminating-tuberculosis-tb-in-central-asia."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Ay\u00e9, R., Wyss, K., Abdualimova, H., and Saidaliev, S. (2010). Patient\u2019s site of first access to health system influences length of delay for tuberculosis treatment in Tajikistan. BMC Health Serv. Res., 10.","DOI":"10.1186\/1472-6963-10-10"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Glushkova, N., Semenova, Y., and Sarria-Santamera, A. (2023). Editorial: Public health challenges in post-Soviet countries during and beyond COVID-19. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1290910"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Zhu, X.-H., Tao, N.-N., Zhang, Q.-Y., Song, W.-M., An, Q.-Q., Liu, S.-Q., Li, Y.-F., Long, F., and Li, H.-C. (2022). Association between diagnostic delay and prognosis of pulmonary tuberculosis in Shandong, China: A retrospective study. BMC Pulm. Med., 22.","DOI":"10.1186\/s12890-022-02101-z"},{"key":"ref_66","first-page":"1","article-title":"Delays in health seeking, diagnosis and treatment for tuberculosis patients in Mongolia: An analysis of surveillance data, 2018\u20132021","volume":"15","author":"Otero","year":"2024","journal-title":"West. Pac. Surveill. Response J."},{"key":"ref_67","unstructured":"(2025, June 15). Mongolia\u2019s Looming Tuberculosis Crisis\u2013The Diplomat. Available online: https:\/\/thediplomat.com\/2023\/11\/mongolias-looming-tuberculosis-crisis\/."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40249-020-00665-8","article-title":"Determinants of delayed diagnosis and treatment of tuberculosis in Cambodia: A mixed-methods study","volume":"9","author":"Teo","year":"2020","journal-title":"Infect. Dis. Poverty"},{"key":"ref_69","first-page":"44","article-title":"The impact of COVID-19 on tuberculosis. Zdravookhranenie Kyrgyzstana","volume":"2","author":"Altymysheva","year":"2023","journal-title":"Sci. Pract. J."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e59","DOI":"10.1016\/S1473-3099(22)00500-X","article-title":"Ending tuberculosis in a post-COVID-19 world: A person-centred, equity-oriented approach","volume":"23","author":"Ryckman","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_71","unstructured":"World Health Organization (2023). 1.1 TB Incidence. Global Tuberculosis Report 2023 [Internet], World Health Organization. Available online: https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2023\/tb-disease-burden\/1-1-tb-incidence."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2100231","DOI":"10.2807\/1560-7917.ES.2021.26.24.2100231","article-title":"Early COVID-19 pandemic\u2019s toll on tuberculosis services, WHO European Region, January to June 2020","volume":"26","author":"Dara","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_73","unstructured":"World Health Organization (2021). 1. COVID-19 and TB. Global Tuberculosis Report 2021 [Internet], World Health Organization. Available online: https:\/\/www.who.int\/publications\/digital\/global-tuberculosis-report-2021\/covid-19."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Gabdullina, M., Maes, E.F., Horth, R.Z., Dzhazybekova, P., Amanova, G.N., Zikriyarova, S., and Nabirova, D.A. (2023). COVID-19 pandemic and other factors associated with unfavorable tuberculosis treatment outcomes\u2014Almaty, Kazakhstan, 2018\u20132021. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1247661"},{"key":"ref_75","unstructured":"United States Agency for International Development (USAID) (2021). Tajikistan TB Recovery Plan to Mitigate the Impact of COVID-19, USAID."},{"key":"ref_76","unstructured":"World Health Organization (2022). Increase in Tuberculosis Deaths and Disease during the COVID-19 Pandemic [Internet], World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/27-10-2022-tuberculosis-deaths-and-disease-increase-during-the-covid-19-pandemic."},{"key":"ref_77","first-page":"e1372","article-title":"Economic Impact of TB Mortality in 120 Countries and What It Will Cost If We Don\u2019t Achieve the End TB Targets: A Full-Income Analysis","volume":"9","author":"Silva","year":"2020","journal-title":"SSRN Electron. J."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/18\/2314\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:44:18Z","timestamp":1760035458000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/18\/2314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":77,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["diagnostics15182314"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15182314","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2025.04.28.25326554","asserted-by":"object"}]},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]}}}