The article presents the analysis of changes in preliminary and estimated epidemiological rates: tuberculosis (TB) incidence, TB mortality, and clinical and social structure of new TB cases. It has been found that against the background of continuing improvement of the epidemic situation (reduction of TB incidence and mortality), the clinical structure of TB cases detected in 2020-2021 deteriorated compared to 2015-2019 which was manifested by higher frequency of pulmonary tissue destruction, massive bacterial excretion (by smear), and fibrous cavernous pulmonary TB. The number of TB cases detected post mortem has increased, as well as one-year mortality. These changes indicate low detection of TB cases in 2020. Changes in the incidence of TB/HIV co-infection and the number of new cases with bacterial excretion and multiple drug resistant TB essentially repeat the changes in TB incidence in the resident population during this period. 

The review considers data from 28 publications devoted to the specific impact of COVID-19 on the course of tuberculosis. It describes diagnosis and clinical manifestations in case of co-infection of these two diseases. Also, it discusses the social impact of lockdowns and restrictive measures taken during the COVID-19 pandemic on the treatment of tuberculosis. The article discusses the impact of BCG vaccination on the immune response to the coronavirus.

The article describes a clinical case of tuberculosis pericarditis associated with HIV infection and COVID-19. The patient underwent additional examination due to abnormalities on his X-ray. Large volume of effusion, its lymphocytic nature, bilateral pleural effusion and bilateral infiltration in the upper lobes of both lungs, intrathoracic lymphoadenopathy were indicative tuberculosis etiology of the disease; the diagnosis of tuberculosis was confirmed by morphological tests. COVID-19 was detected post mortem.

The objective of the study: to evaluate the possible use of the subcutaneous test with tuberculous recombinant allergen (TRA) in the differential diagnosis of pulmonary tuberculosis localized in the upper lobes.
Subjects and Methods. Data of examinations with subcutaneous TRA and Mantoux tests with 2 units in 648 patients aged 18 to 90 years with various lung pathologies and HIV-negative status and 122 healthy individuals were retrospectively analyzed. Among these subjects, the following diseases were diagnosed: tuberculosis, pneumonia, cancer, post-tuberculosis changes, and sclerotic changes after nonspecific diseases.
Results. The sensitivity of TRA test in adults with tuberculous lesions in the upper lobes was 59.87%; the rate of negative responses in those without active tuberculosis was 76.0%; the sensitivity of Mantoux test with 2 units was higher and made 83.6%, but the rate of negative responses in those without tuberculosis was lower – 44.1%. TRA test is most important in the differential diagnosis of tuberculosis and pneumonia in which positive and hyperergic reactions are observed in 59.87 and 13.95% of cases, respectively.
The comparative analysis of the rates for tuberculosis and post-tuberculosis changes showed no statistically significant difference in both Mantoux test (83.6 and 78.4%, respectively, p > 0.05) and TRA test (59.87 and 50.77%, respectively, p > 0.05). This indicates that these tests cannot be used to assess the activity of tuberculosis localized in the upper lobes of the lungs in adults. 

The objective: to study the efficiency and effectiveness of various non-resection ways of pulmonary bleeding control in patients with disseminated fibrous cavernous pulmonary tuberculosis.
Subjects and Methods. A retrospective non-randomized study of complex treatment of 68 patients with fibrous cavernous pulmonary tuberculosis was performed. All the patients received treatment from 2012 to 2020 and the course of their disease was complicated by grade 1 pulmonary bleeding.
Results. The patients were divided into three groups depending on the treatment used. Patients in Group 1 (n = 16) underwent upper posterior thoracoplasty with a mesh implant; all patients (100%) had good results: hemostasis was stable, cavities were healed and there were positive changes in the course of tuberculosis. In Group 2 (n = 15) with valve bronchial block, good results were observed in 86.7% of patients. Patients in Group 3 (n = 37) received conservative treatment supplemented with pneumoperitoneum; a good result was noted in 43.2% of patients.

The objective: to evaluate the current tuberculosis surveillance system in Dushanbe for each of the following parameters: simplicity, flexibility, acceptability, sensitivity, and promptness of response; to provide recommendations to improve the system.
Methods. The tuberculosis surveillance system was evaluated in the city of Dushanbe in April-May 2021 using updated guidelines of the Center for Disease Control and Prevention for evaluating public health surveillance systems, 2006.
Result: The system fulfills its goals and objectives, but has gaps in promptness of response, acceptability and representativeness.
Conclusions. The tuberculosis surveillance system needs to be improved and requires professional development training of family medicine workers, TB specialists, and epidemiologists.

The objective: to identify promising directions for prevention of HIV incidence mortality on the basis of analysis of changes in HIV situation assessing the effectiveness of interventions in penitentiary units.
HIV infection has traditionally been a critical issue for the penitentiary system worldwide and in Russia particularly. Recently, Russia has managed to achieve positive changes in the epidemic situation: by 2020, HIV incidence reduced to 852.8 per 100,000 (including 2,433.6 in remand prisons and 122.8 in correctional institutions); HIV prevalence was 10,512.8 per 100,000; HIV mortality was 98.3 per 100,000; HIV lethality was 0.9 per 100,000 people living with HIV.
The proportion of HIV infection as a cause of death decreased from 32.0 in 2016 to 20.5 in 2020. The positive changes developed faster compared to civilian health care and occurred during the growing coverage with antiretroviral therapy which increased from 21.7% in 2014 to 89.6% in 2020. The following problems persist: high prevalence of HIV infection among female inmates (19,275.0 versus 9,769.2 among male inmates per 100,000), the high proportion of HIV/hepatitis C co-infection (49.0%; 95% CI 48.6-49.5), and the low coverage with hepatitis C treatment (0.5% of the total number of persons with co-infection). Promising directions for the prevention of HIV incidence and mortality are related to stable supply of antiretroviral drugs, improved patient adherence to treatment, and expanding treatment for HIV/hepatitis C co-infection.

A clinical case shows the complexity of the choice of surgical strategy for treatment in drug-resistant bilateral fibrous cavernous pulmonary tuberculosis complicated by pyopneumothorax and empyema of the pleural cavity. A non-standard personalized approach to the patient with initially compromised cardiorespiratory system resulted not only in cure of tuberculosis complications but also improved pulmonary functional parameters and allowed avoiding progression of pulmonary tuberculosis.

This review analyzes 64 publications on repurposed antibiotics and the prospects of their use in the treatment of multiple drug resistant and extensively drug resistant tuberculosis. The article describes mechanisms of action of beta-lactams and macrolides on tuberculous mycobacteria; the results of studies and safety profiles are given.