Significance. A high level of coverage with preventive examinations of labor migrants arriving to work at enterprises in the Kaluga region makes it possible to detect tuberculosis (TB) at an early stage, which is characterized by an asymptomatic course, and with timely treatment it it possible to achieve its effective cure and thereby prevent the TB spread both among migrants and permanent population of the region. However, the majority of TB patients among labor migrant avoid treatment or interrupt the therapy due to lack of funds to pay for treatment. Undertreated patients continue to be sources of infection, often spreading resistant forms of tuberculosis with multidrug resistance of the pathogen. In addition, it is not possible to identify whereabouts of such patients, which fraught with TB spreading among the general population of the region. The purpose of the study: to analyze demographic and clinical factors influencing TB treatment outcomes in labor migrants. Material and methods. The study used information about 357 patients with tuberculosis, newly detected among the resident population of the Kaluga region, and 118 TB patients detected among labor migrants in 2019-2020. For the analysis, a questionnaire was developed, consisting of 9 demographic and clinical factors influencing outcomes of TB treatment. The analysis used information from the federal statistical surveillance forms No. 8 and No. 33 and Rosstat data on the average annual population of the Kaluga region in 2011-2020. To analyze TB treatment outcomes in labor migrants, data of the cohort analysis for 2016-2020 were used. Statistical analysis methods were used for the analysis. Results. In the Kaluga region in 2016-2020, 406 patients with tuberculosis were detected among 142,763 labor migrants examined by fluorography, or 0.3% of the total number. Analysis of a number of factors that affect TB treatment outcomes in labor migrants and the resident population of the Region in 2019-2020 showed that 90.7% of TB cases among labor migrants were detected at an early stage, which is asymptomatic, therefore in epidemic terms, they were much less dangerous compared to those detected among the resident population. However, only 123 patients were signed up for treatment, which accounted for 30.3% of the total number of TB patients among labor migrants, while the remaining 283 patients could not afford to pay for TB treatment and dropped off the TB service radar. Among patients with tuberculosis who started treatment, only 50% were effectively cured, while every third had to interrupt the treatment due to lack of funds to pay for the full course of chemotherapy. Conclusion. In order to reduce TB incidence among labor migrants and ensure free TB treatment in the Russian TB care facilities for labor migrants diagnosed with tuberculosis during their stay in Russia, there is an urgent need to find sources to finance costs associated with their treatment and to develop reimbursement mechanisms through introducing additions to legal documents on provision of medical care to labor migrants in those states where they have a permanent residency.

The objective of the study: to study tuberculosis incidence in migrant workers in Russia from 2010 to 2019.Subjects and Methods: data from Federal Statistical Surveillance Forms No. 8 and 33 for 2010-2019, Federal Migration Service data on the number of migrant workers, and Rosstat data on the population of Russia. Pearson's chi-squared test was used for data analysis.Results. Over the past 10 years in Russia, the steadily decreasing tuberculosis incidence in the permanent population has had no direct impact on the spread of tuberculosis among migrant workers. The high incidence of tuberculosis among migrant workers which is many times higher than the one in the permanent population and reaches its maximum in the youngest age groups (18-24 and 25-34 years old), poses a serious threat to the infection control in the permanent population of Russia.

Over the past 20 years, there has been a steady decline in the incidence of tuberculosis (TB) among resident population in Russia. However, the growth in the number of labor migrants in recent years in Russia increases the risk of the spread of tuberculosis in Russia, imported by migrants from countries with high TB prevalence. Further development of such situation may jeopardize achievement of the TB Control Program targets in the Russian regions with the highest inflow of labor migrants. Purpose: to analyze incidence of tuberculosis among labor migrants in the Kaluga region in dynamics for the period from 2010 to 2019. Material and methods: information from the Rosstat statistical surveillance forms No. 8 and No. 33, Rosstat data on the average annual population of the Kaluga region for 2001-2020, data from the Department of the Ministry of Internal Affairs in the Kaluga region on the number of labor migrants in 2017-2019. Pearson’s chi-square test (χ2) was used for comparative analysis. Results: The decline rate in the overall TB incidence in the Kaluga region over the past decade (2010-2019) equaled to 47%, which is 16.4% lower compared to the rate in the resident population of 56.2%. A slowdown in the decline in the overall TB incidence, which is the key indicator of the TB control program, may compromise achievement of the Program targets in the Kaluga region. A comparative analysis of TB incidence among resident population and labor migrants showed higher values among labor migrants compared to resident population: 7.2-fold in 2017, 4.9-fold in 2018 and 7.4-fold in 2019 (p<0.0000001). Conclusion. A significantly higher TB incidence among labor migrants poses a serious threat to its spread in resident population of the region. To reduce TB incidence among labor migrants, it is necessary to introduce changes into regulatory documents to ensure treatment of labor migrants diagnosed with TB in Russia at TB health facilities.

Introduction. Assessment of dynamics of the overall incidence of both tuberculosis and HIV-infection, without a detailed analysis of its distribution by age, is insufficient to understand the current trends and their forecast from the standpoint of achieving WHO and UNAIDS targets in relation to the elimination of tuberculosis (2035) and HIV-infection (2030). The purpose of the study: to study the age characteristics of the incidence of tuberculosis and HIV-infection in the adult population of Russia in dynamics for 2010-2019. Material and methods: retrospective analysis of the incidence of tuberculosis and HIV-infection, and its age structure for 2010-2019. Results: In Russia, in 2010-2019, the incidence of tuberculosis in the adult population (≥ 18 years) has been steadily decreasing. However, analysis of its distribution by age showed that among young groups (25-44 years) its level was higher and reached the maximum value of 84.6 per 100000 of population in the group of 35-44 years. In recent years, an increase in the incidence of HIV-infection was observed in Russia, and its highest values were recorded among patients from young age groups (25-44 years). Limitations of the study. The analysis of the incidence of tuberculosis and HIV infection in the adult population of Russia was carried out both in general for the entire population and in individual age groups for the period from 2010 to 2019, which seemed sufficient to effectively achieve this goal. Discussion: Retention of high incidence of tuberculosis and an increase in the incidence of HIV-infection among patients aged 25-44 is largely due to widespread prevalence of tuberculosis among patients with HIV-infection. Today in Russia every fourth patient with tuberculosis, both newly diagnosed and among the contingents with TB, is a patient with HIV-infection with manifestations of tuberculosis. Conclusion: In Russia over the past 10 years, an increase in the number of newly diagnosed HIV-infected patients with TB manifestations, which are included in the structure of both the incidence of HIV infection and TB, has led to an increase in the incidence of HIV infection and a slowdown in the rate of decline in the incidence of TB among young age groups.