Системная динамика как инструмент анализа эпидемического процесса туберкулеза

Актуальность. Туберкулез - одна из лидирующих причин заболеваемости и смерти в мире. Согласно данным Всемирной Организации Здравоохранения, эпидемиологическая ситуация по туберкулезу в мире остаётся напряженной, несмотря на тенденцию улучшения показателей заболеваемости и смертности. В связи со сложившейся ситуацией по ТБ на сегодняшний день, несомненно, актуальным остается непрекращающееся изучение механизмов эпидемического процесса ТБ.
Цель. Анализ доступных на сегодняшний день моделей процесса распространения ТБ, основанных на системной динамике, с характеристикой основных предположений, выдвигаемых при моделировании, по данным научной литературы.
Стратегия поиска. Проведен поиск научных публикаций в базах данных PubMed, Scopus, Web of Science, Google Scholar, e-Library. Глубина поиска - 10 лет. Критерии включения: публикации, опубликованные в период с 2010-2020гг., на казахском, русском и английском языках; полнотекстовые публикации, эпидемиологические исследования, основанные на системной динамике. Критерии исключения: повторно встречающиеся публикации, систематические обзоры, публикации с платным доступом. Всего проанализировано 312 публикации, из них 52 включены в данный обзор.
Результаты. Анализ литературных данных установил, что на сегодняшний день большинство исследований по разработке системно-динамических моделей нацелены на прогнозирование эпидемиологической ситуации с использованием локальных данных. Кроме того, незначительное количество исследований проведено с включением сопутствующей патологии, такой как ВИЧ-инфекция, сахарный диабет. Результаты также показали, что отсутствуют работы с комбинацией ряда факторов риска в рамках одной модели, что позволило бы создать более реалистичную проекцию течение эпидемического процесса ТБ.
Выводы. На основании проведенного анализа научной литературы можно сделать вывод, что метод моделирования - системная динамика - обладает высокой функциональностью, позволяя не только осуществлять прогноз эпидемиологической ситуации по ТБ и оценить эффективность стратегий вмешательства, но и произвести оценку влияния ряда факторов риска на течение эпидемический процесс ТБ.

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