Received by the Editorial Office: June 03, 2026
Accepted for publication: June 28, 2026
Published online: June 30, 2026
UDC: 616-002.5(574):614.2:616-07
DOI: 10.26212/2227-1937.2026.58.66.006
TUBERCULOSIS IN KAZAKHSTAN IN THE GLOBAL CONTEXT: A STRUCTURED NARRATIVE REVIEW OF DIAGNOSTIC AND HEALTH SYSTEM CHALLENGES
Kuzembekova Zh.1, Baymuratova M.1, Kassenova M.1,
Ryskulova A.1, Ryskulov G.1,2, Saussanova D.1 , Shakhanova. A.1,2
1Kazakhs Medical University “KSPH”, Almaty, Kazakhstan
2National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan, Almaty, Kazakhstan
Introduction: Tuberculosis (TB) remains one of the leading infectious causes of morbidity and mortality worldwide. Extrapulmonary tuberculosis (EPTB) accounts for a substantial proportion of reported cases and continues to present important diagnostic and health-system challenges, particularly in countries with persistent drug-resistant TB burden.
Objective: To synthesize current global evidence and Kazakhstan-specific data on EPTB, with particular emphasis on diagnostic innovation, primary health care (PHC)-related detection barriers, and priority strategies for strengthening TB control in the post-COVID period.
Methods: A structured narrative review with systematic search procedures was conducted in accordance with PRISMA 2020 reporting principles. Literature published between January 2015 and September 2025 was identified through PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and official institutional sources. From 412 initially identified records, 45 sources met eligibility criteria and were included in the final synthesis.
Results: In 2024, an estimated 10.7 million people developed TB and 1.23 million deaths were attributed to the disease globally. EPTB accounts for approximately 15–16% of reported TB cases, although the true burden is likely underestimated. The COVID-19 pandemic disrupted case detection and continuity of care, exposing structural weaknesses in TB programmes. Kazakhstan has achieved substantial reductions in TB notifications over the past decade and expanded access to molecular diagnostics, digital monitoring, and PHC integration. However, major challenges remain, including a high burden of multidrug-resistant TB, geographic inequalities in access to specialized services, and delayed recognition of extrapulmonary disease.
Discussion: The study demonstrated that effective tuberculosis (TB) control depends not only on biomedical advancements but also directly on the healthcare system’s ability to coordinate diagnosis and treatment. A key finding is that extrapulmonary tuberculosis (EPTB) often remains overlooked clinically due to its non-specific symptoms and the requirement for complex diagnostic methods. The challenges in detecting EPTB in Kazakhstan and neighboring regions necessitate strengthening integration at the primary health care (PHC) level and increasing the clinical alertness of physicians. Furthermore, the effectiveness of innovative treatment regimens for multidrug-resistant tuberculosis (MDR-TB) is limited by the speed of diagnosis and the availability of socio-economic support for patients.
Conclusion: Effective TB elimination requires earlier PHC-based identification of EPTB, equitable access to rapid molecular diagnostics, broader implementation of shorter evidence-based regimens, and resilient patient-centred systems of care. Kazakhstan demonstrates meaningful progress, but accelerated modernization and targeted health-system reforms remain necessary to achieve End TB targets
Keywords: extrapulmonary tuberculosis, tuberculosis epidemic, drug-resistant tuberculosis, innovative technologies, primary health care, Kazakhstan
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