The article presents the data on the prevalence of tuberculosis in the penitentiary units in the countries of the WHO European Region compared to theRussian Federation.

It lists factors providing an impact on the risk of the disease and notification rate of tuberculosis cases in prisons.

Monitoring of tuberculosis in the penitentiary units is described including the formation of notification rates and treatment outcomes. It presents information on the comparatively high quality of tuberculosis monitoring in the penitentiary units of theRussian Federation.

Potential causes of differences between the incidence of tuberculosis in different countries of the WHO European Region are analyzed.

The objective of the study: to investigate the efficiency of three-level algorithm for differential diagnostics of respiratory tuberculosis in those at the terminal stage of chronic kidney disease, verifying the diagnosis by etiologic and morphologic methods.

Subjects and methods. A three-level algorithm was used in 34 patients at the terminal stage of chronic kidney disease in order to verify respiratory disorders detected by X-ray examination. If it was impossible to verify the diagnosis on Level I, invasive methods were added to the examination: bronchoscopy with biopsy, punctures on Level II and surgical interventions (VATS resections) on Level III. Detection of tuberculosis mycobacteria or their DNA was a diagnostic criterion.

Results. Three-level algorithm assured 100% diagnostics in 34 patients at the terminal stage of chronic kidney disease (95% CI 89.6-100). On Level I, diagnosis was verified in 13/34 (38.2%; 95% CI 23.9-55.0) patients, examinations of Level II had to be used in 21/34 (61.8% 95% CI45.0-76.1) patients, which allowed defining the diagnosis in 15/21 (71.4%; 95%CI 50.0-86.2) patients. Examinations of Level III were needed in 6/34 (17.7%; 95% CI 8.4-33.5) patients, and diagnosis was verified in all of 6/6 (100%; 95% CI 61.0-100).

Among diseases detected in 34 patients at the terminal stage of chronic kidney disease, respiratory tuberculosis prevailed – in 19 (55.9%; 95% CI 39.5-71.1) patients; the majority of tuberculosis patients – 9/19 (47.4%; 95% CI 27.3-68.3) was detected on Level II of examination, including 2 patients with bronchial tuberculosis. On Level I, non-specific pulmonary diseases were detected in the majority of patients – 8/15 (53.3%; 95%CI ДИ 30.1-75.2).

Microbiological diagnostics of tuberculosis was effective when examining the following specimens: sputum (Level I) in 5/19 (26.3%; 95% CI 11.8-48.8) patients, biopsy specimens (Level II) – in 9/14 (64.3%; 95% CI 38.8-83.7) patients; surgical specimens (Level III) – 5/5 (100%; 95% CI 56.6-100). When using three level diagnostic algorithm, the following tests were success: fluorescent microscopy – in 7/19 (36.8%; 95% CI 19.2-59.0) cases; culture on liquid media in Bactec MGIT 960 – in 17/19 (89.5%; 95% CI 68.6-97.1) cases, realtime PCR – in 19/19 (100%; 95% CI 83.2-100) cases. Multiple/extensive drug resistance was detected in 11/17 (64.7%; 95% CI 41.3-82.7) patients (the part of XDR made 11.8%).

The objective: to optimize detection of tuberculosis in a pulmonology unit.

Subjects and methods. In a pulmonology unit, patients suspected of having tuberculosis had a minimum number of diagnostic tests: a skin test with tuberculous recombinant allergen, three consecutive Ziel-Nelson microscopies of sputum and fluids of bronchoalveolar lavage, and in the laboratory of TB services they performed GeneXpert MTB/RIF, Bactec MGIT. Results of the diagnostics were analyzed in 70 patients with etiologic confirmation of diagnosis.

Results. A targeted inquiry and taking the patient's history were informative in 4% of cases, skin test with TRA – in 27.1%, GeneXpert MTB/RIF – в in 100%, and Bactec MGIT – in 97.1%. Introduction of express diagnostic methods to a pulmonology unit reduced the average number of bed-days from admission to diagnostics of tuberculosis and transfer to a TB in-patient unit down to 9.80 ± 4.72 days. Molecular genetic methods can be recommended for introduction to general medical services as a diagnostic minimum when examining patients with a high risk of tuberculosis.

Currently, there are no doubts about the relevance of surgery as a part of integral treatment. However, minimally invasive surgeries for treatment of pulmonary tuberculosis are rarely used due to post-inflammatory changes in the pleural space and lung root. And outcomes of robot-assisted lobectomies in pulmonary tuberculosis patients have never been investigated.

The objective of the study: to investigate the efficiency and safety of robot-assisted surgeries in pulmonary tuberculosis patients.

Subjects and methods. Since May 2013, 56 patients suffering from focal unilateral pulmonary tuberculosis were enrolled into a prospective study, after having an adequate course of anti-tuberculosis chemotherapy. At the moment of surgery, bacillary excretion persisted in 32% of patients, and 90.5% of patients had cavities.

Results. All patients had robot-assisted lobectomies using the surgical system of Da Vinci Si. The average time of surgery made 174 minutes (90-380 minutes), the blood loss made 82 ml (10-500 ml). In 2 (3%) patients, a robot-assisted access was converted into lateral thoracotomy. The frequency of post-operative surgical complications made 25% [6].

Conclusion. High clinical efficiency and safety are associated with robot-assisted lobectomies as a part of the integral treatment of pulmonary tuberculosis patients.

The article presents the analysis of outcomes of short course treatment of tuberculosis patients with multiple drug resistance (MDR TB), which was twice shorter compared to standard treatment (9-12 months versus 20-14 months). The efficiency of short-course and standard treatment did not differ significantly in new MDR TB cases and those previously who had limited tuberculous lesions and received no therapy with second line drugs in the past (69.2% versus 68.2%), while the default rate was twice less (13.5% versus 27%, p = 0.03). Economic efficiency of treatment: costs of drugs for short-course treatment of MDR TB were 3 times lower compared to the standard one.

The objective of the study: to analyze the legal regulation of tuberculosis care provision to the population ofRussia at the turn of the XIX-XX centuries.

Methods. Systemic analysis of RSFSR regulations, scientific literature and archive information devoted to tuberculosis care provision during the examined period.

Results. Certain problems of legal regulation in the organization of anti-tuberculosis care at the turn of the XIX-XX centuries were detected.

Conclusion. The article concludes that in the 20s of the XX century in RSFSR, TB services were set up, an organization of anti-tuberculosis care was regulated by the state, social support for tuberculosis patients was guaranteed, but unfavorable social and economic conditions existing in the country did not allow stopping the transmission of tuberculosis.