The objective: safety assessment of chemotherapy regimens compiled in accordance with the recommendations of World Health Organization (WHO), 2019, in patients with multiple drug resistant tuberculosis (MDR) in clinical practice settings.

Subjects: Frequency, patterns, severity and risk factors of adverse events (AE) of chemotherapy regimens compiled in accordance with the WHO recommendations as of 2019 were analyzed in 122 patients with MDR and XDR respiratory tuberculosis within programmatic use of new anti-tuberculosis drugs.

Results. The frequency of AE made 64.8% (95% CI 55.9-72.7%), gastrointestinal, cardiovascular and allergic events prevailed, the comorbidity was the risk factor of AE development (OR 6.44; 95% CI 1.91-21.76). AEs of with severity degrees 3-4 were observed in 24.6% (95% CI 17.8-33.0%), neurotoxic, ototoxic and hepatotoxic reactions prevailed; risk factors included female sex (OR 3.15, 95% CI 1.32-7.53) and complications of chemotherapy in the past (OR 3.50%, 95% CI 1.49-8.70). At least one anti-tuberculosis drug was canceled due to AE in 26.2% (95% CI 19.2-34.7%), and any of Group A drugs was canceled during the first 6 months of chemotherapy in 13.9% (95% CI 8.8-21.3%) of patients.

Objective: to study the prevalence of latent tuberculosis infection (LTBI), risk factors for LTBI to develop into active tuberculosis, the efficacy of preventive treatment in those with LTBI among labor migrants, residing in the Republic of Tajikistan.

Subjects and methods. In the Republic of Tajikistan, 500 residents were followed up as Main Group, they all were labor migrants for more than 3 months and returned to their homeland within one year before inclusion in this study. All of them participated in a questionnaire survey to identify risk factors for developing tuberculosis and had the examination that included Mantoux test with 2 TE and chest X-ray. Comparison Group (CG) consisted of 500 citizens of compatible gender and age who did not travel as labor migrants; they all participated in the same survey and had the same examination.

Results. The positive results of Mantoux test with no abnormalities on X-ray were observed in 40% of people in Main Group and 33.4% of people in Comparison Group.
The following factors were found to be more frequent in Main Group versus Comparison Group, respectively: frequent and continuous exposure to a TB case – 78.2 and 23.1% (p < 0.01); no tuberculosis prevention – 83.1% and 48.4% (p < 0.01); poor accommodation and work conditions 87.9 and 13.6% (p < 0.01); inadequate diet and lack of proper clothes – 79.4 and 24.3% (p < 0.01); limited access to medical care – 85.4 and 22.6% (p < 0.01). MG was found to have a higher summarized risk coefficient (r = 4.75) versus CG (r = 2.0), p < 0.01. During 2–3-year follow-up of those with LTBI who had no preventive treatment with isoniazod, tuberculosis was diagnosed in 44.4% of people from MG and 18.5% of people from CG. The introduction of the integrated approach to tuberculosis control among people preparing for labor migration allowed reducing the proportion (from 19.7 to 13.7%) of labor migrants in the structure of TB incidence.

The objective: to investigate the cytokine potential (TGF-β1, TNF-α, IL-1β, IL-4) in the systemic blood circulation of patients who successfully completed treatment for pulmonary tuberculosis, depending on whether they have chronic obstructive lung disease (COPD).

Subjects and methods. The study included 118 patients who had successfully completed treatment for pulmonary tuberculosis by the time of the examination. Group 1 included 79 patients with different forms of pulmonary tuberculosis without COPD, Group 2 – 39 patients with different forms of pulmonary tuberculosis and concurrent COPD. The Control Group consisted of 24 healthy individuals.
In all patients, the levels of IL-1β, TNF-α and IL-4, as well as the active form of TGF-β1 were tested in the systemic blood circulation using commercial ELISA test systems.

Results. By the time of successful tuberculosis treatment completion, COPD patients were found to develop the following: a special Th2-associated form of immune imbalance characterized by the reduced systemic level of TNF-α in combination with the increased level of IL-4; the increased risk of development and progression of pulmonary fibrosis due to the high level of growth factor TGF-β1 (in comparison with patients without COPD); elevated levels of TGF-β1 (compared with patients without COPD), creating favorable endogenous conditions for tuberculosis relapse.

The objective of the study: to analyze certain parameters of immune status in children with complications after BCG/BCG-M vaccination.

Subjects and methods. The immune status parameters were tested in 24 children who developed complications after TB vaccination such as BCG-ostitis, BCG-lymphadenitis. Lymphocyte population was assessed using flow cytofluorometry by Cytomics FC 500 (Bekman Coulter).
The serum level of immunoglobulins IgG, IgA, IgM was tested by immunodiffusion in Mancini agar. The leukocyte phagocytic activity was tested using flow cytofluorometry (Cytofluorimeter Cytomics FC 500) with FITC-labeled staphylococcus.

Results. Of the 24 children with BCG lymphadenitis or BCG ostitis, 22 (92%; 95% CI 73-99%) had abnormality in immune status.
Of the 24 children, 7 had low CD3⁺ count, while 9 had an elevated level of CD3⁺ . The level of СD4⁺ was low in 4 children and elevated in 15 pediatric patients. CD8⁺ count was low in 21 children (88%; 95% CI 72-97%). 11 children had low СD16⁺ number, and it was elevated in 2 children. In 10 children, low level of СD16⁺ was combined with low level of CD8⁺ . 10 children had low СD19⁺ number, and it was elevated in 4 children. The leukocyte phagocytic index drastically decreased (down to 37%) only in 1 child, and in 23 children, it varied from 60 to 90%.
IgG level was low in 13 (54%), and elevated in 2 (8%) children. IgA level was low in 6 (25%), and it was not detected at all in 8 (33.3%) children. IgM level was elevated in 4/24 (17%) children, while it was low in 1/24 (4%). In 8 children with no IgA detected, the IgG level was low in 5 of them, 3 had a normal level, and IgM level was elevated in 2 children, 6 children had a normal level of IgM. With IgA completely absent, 1 child had the normal level of IgG and IgM.

The objective of the study: to assess the efficacy of complex treatment with endobronchial valve implantation in the patients suffering from drug resistant fibrous cavernous pulmonary tuberculosis.

Subjects and methods. Treatment outcomes in 97 patients with limited fibrous cavernous pulmonary tuberculosis were analyzed. Main Group included 42 patients who had bronchial valve block implanted. Comparison Group included 55 patients. Artificial pneumoperitoneum was used in both groups.

Results. In Main Group, sputum conversion was achieved in 12 months in 40 (95.2%) patients, and in 32 patients (58.2%) in Comparison Group (p < 0.01). In 12 months after treatment start, positive X-ray changes were observed in 42 (100%) patients of Main Group and 40 (72.7%) patients of Comparison Group. Healing of cavities in 12 months was observed only in the patients from Main Group (26 (61.9%) patients). Upon completion of the study, surgery was still indicated to 4 (9.5%) of patients from Main Group and to 35 (63.6%) patients from Comparison Group.

The objective: to study the perception of the problem of tuberculosis in physicians working in primary medical care and enhance motivation to implement tuberculosis control activities.

Subjects and methods. A questionnaire survey was conducted in 114 physicians from primary medical care before and after the lecture on phthisiology. A subjective assessment of the knowledge on tuberculosis (self-assessment) and results of an objective assessment were studied and compared.

Results. 30% of physicians had the fear of getting infected and developing tuberculosis. The level of theoretical phthisiologic knowledge among physicians from primary medical care is insufficient; the self-assessment of this knowledge is overstated in 58.8%.

The article describes 2 cases when granulomatosis with polyangitis (Wegener's disease) were diagnosed in the regional TB dispensary. Publications on the main clinical, radiological and morphological manifestations of granulomatosis with polyangitis were reviewed, the specific parameters required for differential diagnosis of this disease from tuberculosis were highlighted. This article demonstrates the need for the interdisciplinary approach to the differential diagnosis of tuberculosis.

The review presents data on the frequency of detection of drug resistant (DR) tuberculosis mycobacteria (MTB) as well as on the change in DR patterns in Russia and abroad from the mid-50s of the 20th century till the present. Along with the well-known mechanisms for DR MTB development, it tells about new research describing mutations associated with drug resistance.