The study aims to determine what forms of tuberculosis (TB) are the most common in high prevalence region, establishes the drug sensitivity of Mycobacterium tuberculosis in the region, and reveals the key risk factors of the disease as well as assesses the health status of adolescents with tuberculosis. For 10 years, regional anti-tuberculosis hospital in Smolensk has been collecting data from all TB patients aged 14-34 years. Diagnosis of tuberculosis was based on specific radiological data and detection of M. tuberculosis in sputum or bronchial lavage fluid. In total, the study involved 129 TB cases in adolescents aged 14-17 and 420 TB cases in young people. Sixty-five adolescents had close family or periodic contact with TB patients (50.6%), but only eight out of 65 (12%) had received complete course of chemistry prevention. Sixty-two adolescents had social risk factors (48%). Those patients significantly more often had extended pulmonary TB (28.3% versus 16.7%), complicated (36.7% versus 16.9%), and destructive (41.7% versus 26.2%) cases. Eighty out of the 129 (62%) had one or more concomitant diseases; they had significantly higher rate of extended and complicated TB cases. Two hundred and fourteen out of the 420 young patients had drug resistance of M. tuberculosis. Resistant TB cases significantly more often developed in unemployed (83.2% versus 71.8%), heavy drinkers and smokers (59.3% versus 43.7%), and in ex-prisoners (26.6% versus 15%). In conclusion, a comprehensive approach to examination and treatment of adolescents with TB should be performed. History and clinical data can be beneficially used to predict of drug resistance before results of cultural investigation.

In Russia, the epidemic situation for tuberculosis has stabilized with a tendency to improvement, according to the dynamics of the main indicators for the disease. However, the problem of tuberculosis infection is still far from being resolved, which is largely due to the development of drug resistance of the infectious agent to the main anti-TB drugs. The purpose of the study is to form macro-structures of the Russian market of anti-TB drugs for 2008 and 2018 and analyze the dynamics of their structural changes. Materials and methods. The State registers of medicines of the Russian Federation for 2008 and 2018 were analyzed. Into account were taken following characteristics of the range: the number of registered anti-TB drugs, dosage forms, dosages, manufacturers, and the number of combined anti-TB drugs. The necessary data was obtained using the content analysis method. The results of the study allowed us to build macro-structures of the Russian market of anti-TB drugs and compare the indicators in the dynamics over 10 years. Results. Over the past 10 years, about 500 anti-TB drugs have been registered and re-registered in the Russian Federation. The range of the selected segment was supplemented by the 3rd new series, which according to 2018 included 166 (30.0%) drugs, taking into account all dosage forms and dosages. The group of anti-TB drugs of the 2nd series in 2018 was the leader in the selected segment (52.2%) and there was a tendency for its growth. In the structure of the assortment of medicinal forms of anti-TB drugs, tablet drugs prevailed (43.5%). The production vector has shifted towards domestic manufacturers. The share of new drugs put into circulation in 2008-2018 was 37%. The nomenclature of the Russian anti-TB market corresponds to international recommendations and contains the main groups of drugs. Conclusion. Analysis of the segment of anti-TB drugs in the domestic pharmaceutical market showed that the phthisiological service has a sufficient range of drugs for the treatment of tuberculosis infection, including those with drug resistance of the pathogen. This allows to personalize therapy based on the stage and severity of the disease, the functional characteristics of the patients body, and the sensitivity of the pathogen to chemotherapy.

The objective: to study the epidemiological rates of tuberculous meningitis (TM) in Smolensk and Kaluga Oblasts in 2015-2020.Subjects and Methods. 51 medical fles (Form no. 003-u) of patients with TM were analyzed, those patients were treated in in-patient settings in Smolensk and Kaluga Oblasts over a 6-year period (2015-2020).Results. The proportion of TM signifcantly correlates with the prevalence of HIV in 2 Oblasts (r = 0.953, p = 0.140 and r = 0.978, p = 0.095, respectively), which allows stating that HIV is the main risk factor for the development of TM. Tuberculous meningitis is more common in men (70.6%) of working age (94.1%), unemployed (60.8%), in combination with pulmonary tuberculosis (64.7%). Late diagnosis of TM is registered in ⅔ of cases; patients fail to undergo the mandatory minimum diagnostic examination. Among patients with HIV infection, TM more often develops in men (90%) of working age (100%), who do not have a regular job (80%), against the background of risk factors (drug addiction, hepatitis C, experience of incarceration), duration of HIV infection up to 10 years and recurrence of tuberculosis. Among HIV positive patients, a severe state, generalized forms of tuberculosis, including lung lesions with scanty bacterial discharge in sputum are registered in 100% of cases.

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Материалы и методы. Проведены анализ заболеваемости туберкулезом у детей и ее сравнение с эпидемиологическими показателями по туберкулезу у взрослых в 2014-2018 гг. Изучены первичная инфицированность детей микобактериями туберкулеза, структура III и IV ГДУ. Проанализированы все случаи впервые выявленного туберкулеза у детей в возрасте от 0 до 17 лет в 2014-2018 гг. Результаты. Показатели заболеваемости туберкулезом детей в Калужской области в 2014-2018 гг. имели разнонаправленные тенденции. Темп прироста показателя составил 0,9%, что выше прироста показателя общей заболеваемости и косвенно свидетельствует о наличии источников заражения среди взрослого населения. Не установлено статистически значимой корреляционной связи между показателями общей заболеваемости туберкулезом и заболеваемостью с бактериовыделением (r = 0,9; p > 0,05), а также между заболеваемостью с бактериовыделением и заболеваемостью туберкулезом у детей (r =-0,48; p > 0,05). Это указывает на дефекты в работе бактериологической службы, а также недовыявление детей из контактов с бактериовыделителями. Заболеваемость детей, состоящих на учете по контакту с больным туберкулезом,