The objective: to justify the optimal duration of chemotherapy with Lzd and Bdq by evaluating the long-term treatment outcomes in patients with multiple/pre-extensive drug resistant (MDR/preXDR) tuberculosis who interrupted treatment at different time points.Subjects and Methods. 800 patients with MDR/preXDR tuberculosis were enrolled in the study, they were from all regions of the Russian Federation and they started a course of chemotherapy with regimens containing Lzd and Bdq in 2017-2018. All patients who interrupted their chemotherapy (124) were divided at 4 groups. Group 1-43 patients who received less than 90 doses, Group 2-37 patients who received from 91 to 180 doses, Group 3-39 patients who received from 181 to 270 doses, and Group 4-5 patients who received from 271 to 360 doses of anti-tuberculosis drugs.Results. In Group 3, the effectiveness of reaching a favorable outcome during observation for 3-4 years made 53.8% in 21/39, which was comparable to the effectiveness of treatment with a 24-month course of chemotherapy (2017 – 58.0 and 2018 – 52.1%). The treatment duration of patients from Group 3 was additionally analyzed, the arithmetic mean of the number of administered doses makes 262 ± 15, which allowed recommending 9-month courses of chemotherapy.

Background. Iron deficiency anemia (IDA) remains a pressing pediatric issue to date. Despite the availability of clinical guidelines and other publications that highlight the objective causes for the lack of effectiveness of treatment and prevention of IDA in children, the subjective reasons are unrenowned.Objective. The aim of the study is to evaluate health beliefs of pediatricians and parents on the problem of anemia in children to investigation into the objective and subjective causes for inadequate control of iron deficiency conditions in childhood.Materials and methods. In September 2022, single-step parallel survey of pediatricians and parents on the problem of IDA in children was conducted by random sampling technique using original questionnaires. The questions were formulated on five topics and related to a common understanding of the term “anemia”; priority reference sources; availability of diagnosis of IDA in medical institutions (MI); the position of pediatricians and parents on the treatment and prevention of IDA in children. Based on the results, the main subjective and objective barriers to the control of IDA in children are identified. The χ2 method was used for the comparative evaluation of the responses. The differences were considered significant at statistical significance of p < 0.05.Results. Pediatricians (n = 81) and parents (n = 363) from 23 members of the Russian Federation took the survey. Among the objective barriers to the IDA control in children, the low availability of serum ferritin in MI, difficulties of venous access in children, a shortage of a range of iron preparations for children on Russian market were revealed. The subjective barriers were the skepticism of pediatricians and parents about the necessity for conservative prevention of IDA; poor knowledge of the criteria for diagnosis IDA and completion of IDA therapy by pediatricians; insufficient independence and selectivity of pediatricians when prescribing iron preparations; orientation of the majority of parents (93.7%) to the opinion of doctors, along with the actual rarity of full-fledged conversations with a pediatrician (16.3%).Conclusion. The main limitation of this study was the random sample method inclusion of respondents due to the impossibility of conducting a full-fledged population study. Elimination of the revealed subjective and objective factors can contribute to improving the detection of IDA in children, early appointment and higher effectiveness of treatment, reducing the frequency of disease recurrences, as well as increasing the confidence of parents in pediatricians.

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Background. The guidelines on selection between iron preparations, iron sulfate (IS) and iron III hydroxide polymaltose complex (HPC), for iron deficiency anemia (IDA) management in pediatrics are contradictory.Objective. The aim of the study is to compare efficacy and safety of iron (III) HPC and IS for IDA treatment in children.Materials and methods. Randomization of children (aged from 1 month to 18 years) with IDA into 2 therapeutic groups was implemented in 2019–2020. on pediatric districts of children’s city outpatient’s clinic: IS dosage of 3 mg/kg/day and iron (III) HPC dosage of 5 mg/kg/day. Hemogram monitoring was performed every 14 days. The efficacy was compared according to the rate of Hb level increase, erythrocytes indices, and serum ferritin (SF) level at the recorded moment of Hb normalization. For the safety — the rate of adverse effects.Results. 65 children with IDA were included in the study and randomized into 2 groups, the median age was 2.3 years (1st; 3rd quartile = 1.1; 4.3). Hb level increase was comparable in both groups (0.34 (0.23; 0.48) g/L/day and 0.24 (0.21; 0.30) g/L/day, р = 0.891). IS is more effective than iron (III) HPC in terms of average red blood cell volume by the time of Hb normalization (83.5 (80.0; 86.7) fl against 80.7 (79.0; 82.0) fl, р = 0.006), and mean cellular hemoglobin content (28.9 (SD = 2.0) pg against 27.4 (SD = 1.8) pg, р = 0.004). The timing of SF levels normalization did not differ. Adverse effects to iron III HPC treatment occurred 5.5 times more frequently than to IS (p = 0.0001).Conclusion. The efficacy of IS and iron III HPC at standard doses is comparable. The advantage in tolerability and recovery of erythrocytic indices justifies the feasibility of using IS preparations in the first line of treatment for children with IDA.