The article presents data on one of the main epidemiological rates defining the burden of tuberculosis in the system of WHO global statistics – tuberculosis mortality. The article describes in detail the WHO assessment of this rate and provides main data on the evaluation and notification of lethal cases due to tuberculosis in certain countries, WHO regions and worldwide. Data presented in the article include the comparison of definitions of mortality and values of registered mortality due to tuberculosis, obtained in Russia, worldwide and countries of WHO European Region. The article discusses if it is possible to achieve indicators set up in the WHO Stop TB Strategy (1990-2015) and WHO End TB Strategy (2016-2035).

Goal of the study: to investigate the informativeness of tuberculous mycobacteria detection by various techniques and to analyze the intensity of bacillary excretion in tuberculosis patients depending on their HIV status.

Materials and methods. 360 HIV patients were examined due to suspected tuberculosis. The diagnostic procedure included two consecutive sputum test for acid fast bacilli (AFB)/tuberculous mycobacteria by fluorescent microscopy, molecular genetic tests and culture on liquid and solid media. Tuberculosis was diagnosed in 178 (49.4%) patients. The comparison group included 354 tuberculosis patients with negative HIV status including 113 patients who underwent the same diagnostic procedure as those suffering from TB/HIV co-infection.

Results of the study. AFB were more often detected by fluorescent microscopy in HIV negative tuberculosis patients compared to those with TB/HIV co-infection (32.8 and 24.2% respectively), and the sensitivity of the other testing methods did not differ. Scarce bacillary excretion was confidently more often registered in those suffering from TB/HIV co-infection and less frequently they had massive bacillary excretion detected by culture on solid media compared to HIV negative tuberculosis patients. The complete diagnostic procedure demonstrated better sensitivity in those with TB/HIV co-infection compared to tuberculosis patients with negative HIV status (87.1 and 71.2%).

Goal of the study: to investigate risk factors and structure of clinical forms of new pulmonary tuberculosis in women in Voronezh Region

Materials and methods. During 2011-2015 in Pokhvisneva Voronezh Regional TB Dispensary the retrospective study was conducted enrolling 909 new female pulmonary tuberculosis cases living on the territory of Voronezh Region. The data of Statistic Report 089/у on New Case Notification were analyzed. The retrospective comparative analysis of data on female tuberculosis patients living in Voronezh and Voronezh Region was conducted.

Results. Women of reproductive age prevailed among new female respiratory tuberculosis cases. Women living in urban settings suffered more often from infiltrate pulmonary tuberculosis with bacillary excretion. The specific features of pulmonary tuberculosis among female patients living in rural settings of Voronezh Region compared to those residing in urban areas are the following: higher frequency of severe forms of the disease (disseminated tuberculosis and caseous pneumonia) and post mortem detection of pulmonary tuberculosis and higher frequency of bacillary excretion.

Tuberculosis is very common among health care workers on the territory of theKyrgyzRepublic. Tuberculosis incidence among health care workers in theKyrgyzRepublicmade 106.34 per 100,000 population in 2014. Tuberculosis epidemiological situation among health care workers especially those facing the advanced risk is unstable and requires undertaking additional measures aimed at its early detection and prevention.

The article presents the investigation results of the specific epidemic situation on tuberculous infection in Omsk Region in 2006-2015 and molecular genetic features of M. tuberculosis strains with multiple drug resistance circulating in this region. Bacteriological, molecular genetic methods, VNTR-typing were used as well as descriptive techniques of the epidemiological process. Tuberculosis prevalence made 269.2 per 100,000 population. There is an increase in those with bacillary excretion among new cases of respiratory tuberculosis from 39.8% to 53.4%. Drug resistance was detected in 48.0% of new cases. Among drug resistance patterns, MDR made 57%, and extensive drug resistance (XDR) increased from 2.5 to 7.0%. In 2015 prevalence of XDR tuberculosis made 8.9 per 100,000 population in Omsk Region. When performing VNTR-typing of 77 samples of M. tuberculosis DNA with MDR, 27 genetic types were identified. The population of MDR strain of M. tuberculosis is heterogeneous and presented by strains of various genetic families -Beijing, LAM, S,Haarlem,Uganda. The investigation showed that isolates ofBeijing family prevailed (76.6%).

Goal: reconstruction of epidemic transmission of Beijing genotype of Mycobacterium tuberculosis on the territory with limited migration based on the comparative study of 153 isolates isolated from patients of different generations in theSakhaRepublic (Yakutia).

Materials and methods. The structure of Mycobacterium tuberculosis population was described and analyzed through MIRU-VNTR-genotyping, subtyping of the parts of RD105/RD207 genome, pattern classification as per clonal pattern of Merker M. et al (2015), and phylogenetic simulation.

Results. It was found out that highly transmissive subtypes of Beijing genotype having a high potential of developing drug resistance was confidently more prevalent (χ2 = 8.3, p < 0.01) among younger people (born after 1990) compared to the older generation (born before 1959). It was also found out that during previous five decades a certain shift occurred in the structure of M. tuberculosis population.

Conclusion. The obtained data confirm the hypothesis that epidemic sybtypes ofBeijing genotype were brought to the territory of theSakhaRepublic (Yakutia) fairly recently (approximately fifty years ago) compared to the other regions ofRussia.

The main problem for treatment of children with various manifestations of tuberculosis is the lack of pediatric dosages of anti-tuberculosis drugs. Considering the current problems when providing treatment it is important to use combined medications with fixed pediatric dosages, which would significantly help to simplify the administration of medications and to relieve the psychological, emotional and physical load when taking a significant number of drugs.

Goal of the study: to define the efficiency of using fixed doses of the medication combing 150 mg of isoniazid, 375 mg of pyrazinamide, 150 mg of rifampicin. Clinical, X-ray and laboratory rates were assessed during treatment of 73 children suffering from respiratory tuberculosis, of them 34 children were treated by the medication combing 150 mg of isoniazid, 375 mg of pyrazinamide, 150 mg of rifampicin plus ethambutol, and the other children were treated by the standard chemotherapy. The opportunity of effective use of the medication combining 150 mg of isoniazid, 375 mg of pyrazinamide, 150 mg of rifampicin in children was confirmed by positive results by the completion of the intensive phase of treatment as well as the continuation phase and minimization of adverse reactions during treatment. The combination of active components of the medication and doses is convenient for use, allow conducting directly observed treatment and enhancing the efficiency of chemotherapy.

The sensitivity levels of 12 fungal species of Aspergillus, identified when diagnosing pneumonomycosis in tuberculosis patients, to 10 antifungal agents were identified and analyzed. The sensitivity of 202 strains of Aspergillus spp. to antifungal agents was tested by microdilution methods defining minimal inhibitory concentrations in μg/ml (Sensititre system). It was found out that agents causing aspergillosis differed in the level of their resistance to the medication of amphotericin B. Three species with poor sensitivity to this medication were identified: A. terreus (possesses natural resistance to amphotericin B), and A. flavus and A. ochraceus (it is reasonable to test sensitivity to amphotericin B prior to the treatment start). Voriconazolum, intraconazolum and pozaconazolum were found to be active against Aspergillus spp. fungi, but for certain strains of A. ustus (the fungus with poor sensitivity to medications of the azolum group, the sensitivity to be tested prior to the start of treatment) as well as some strains of A. nidulans and A. niger. The article describes a modified method for preparation of Aspergillus spp. spore suspension enhancing safety of sensitivity testing and reliability of the results.