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Goal: to investigate specific methods of tuberculosis control teaching to students of Pediatric and General Medicine Department at Phthisiology and Pulmonology Department of Siberian State Medical University subordinated to the Russian Ministry of Health.Materials and methods. Main training curricula and teaching programmes for professional lines of 31.05.01 on General Medicine and 31.05.02 on Pediatrics, students' questionnaires.Results. The article presents the experience of self-tuition of students while preparing to practical training in tuberculosis control in order to enhance the efficiency of mastering this topic, to form positive motivation to have training and productive activities, to develop the skills of information collection and its compilation for public presentation; it describes the task teachers face when implementing Federal State Educational Standard of Higher Education.Conclusions. It is necessary to optimize the training in order to enhance the self-tuition of students when preparing for practical training in tuberculosis control; new forms of training are to be introduced.

The purpose of this paper is to compare the results of immunological tests (tests with recombinant allergen TB in standard dilution (RAT) and the Mantoux tuberculin test) in children at risk of developing tuberculosis in Tomsk Region.Materials and methods. A retrospective analysis of 1204 outpatient medical records of children and adolescents at the age from 1 to 16 was performed.Results. When two tests are carried out at the same time (skin test with RAT (Diaskin-test) and Mantoux tuberculin test), the proportion of positive reactions to tuberculin was 92,4%, including 6,6% of hyperergic reactions, while there were 6,0% of positive reactions to RAT, including 3,2% of hyperergic reactions. The biggest number of positive reactions to RAT was recorded among children with severe and hyperergic tuberculin sensitivity (28,7%) and children from tuberculosis prevalence areas (17,5%). The lowest number of positive reactions to RAT was recorded among children with conversion of tubercular tests and children with latent TB infection (LTBI) – 2,8% and 1,5% respectively.Conclusions. The results of skin tests with RAT as compared to the tests with tuberculin are different. When there is a conversion of tubercular test the positive reaction to Diaskintest was detected only in a few cases (2,8% of cases) as compared to prevailing (in 96,4% of cases) positive reaction to tuberculin; in children with severe and hyperergic results the tuberculin reaction to RAT was the same in every third child (28,7%); in children with increasing sensitivity to tuberculin the immunological response during Diaskintest was detected in 4,7% of cases.More often local forms of tuberculosis were detected among children with hyperergic reactions to skin tests with RAT (12 of 38 children, 31,6%), χ2 = 306,3; p

Evaluation of proliferative and IL-2-producing activity of peripheral blood lymphocytes wasperformed, using cultural methods, in patients with drug-sensitive and drug-resistant infiltrative pulmonary tuberculosis. The cell testing was performed at basal level and following in vitro stimulation with recombinant IL-2 and M. tuberculosis antigens. It was established that clinical course of infiltrative pulmonary tuberculosis, independently on drug sensitivity/resistance of the infectious pathogen, is accompanied by suppression of spontaneous lymphoproliferation. The levels of induced IL-2 production in drug-sensitive tuberculosis proved to be increased, whereas a reserve of IL-2-secreting reactivity of blood lymphocytes was lower than in drugresistant infection. Also, it was revealed that the level of lymphoproliferative response induced by IL-2, does not depend on clinical variant of tuberculosis, whereas stimulation of IL-2 production in blood lymphocytes is attained only in cases of drug-resistant tuberculosis variant.

The social, clinical, radiological, and bacteriological causes of DOTS-PLUS failure were analyzed. According to the findings, diagnosis at the early stage of fibrocavernous tuberculosis, respiratory failure, or hemoptysis in the presence of chronic bronchitis, gastrointestinal and urinary tract diseases, as well as in prison increased the risk of poor therapy outcome. Massive bacterial excretion, high rate of secondary resistance development in Mycobacterium tuberculosis, and its drug resistance to five agents or more are maximally associated with treatment failure in patients with multidrug-resistant tuberculosis.

The comparative analysis of features of clinical symptoms, spectrum and the importance of burdening medico-social factors of a tuberculosis of lungs with primary MDR М. tuberculosis in comparison with a drug sensitive variant of disease is carried out. Presence of associations between burdening factors of disease and MDR М. tuberculosis is proved. We defined degree of risk of detection MBT with MDR at new cases tuberculosis of lungs with narcotism, a tobacco smoking, a syndrome of alcoholic abuse, stay in imprisonment places, a diabetes of 2nd type, hepatitises B, C, В + С.

The appointment of anti-TB drugs with meningitis tuberculous etiology later than the 10th day of illness in most cases leads to an unfavorable outcome of the disease and the development of serious complications. Specific therapy, conducted by the anti-TB drugs, with a high degree of penetration into the cerebrospinal fluid (isoniazid, pyrazinamide, amikacin, ethionamide) makes it possible to avoid fatal outcome in tuberculous meningitis in children, even at very late diagnosis. For suspected meningitis, and that it cannot be excluded, it is necessary to appoint a trial therapy 3—4 anti-TB drugs while there is a specification of the diagnosis.

In the educational program of the Chair of Tuberculosis and Pulmonology of Siberian State Medical University (Tomsk), there is a special consideration towards tuberculosis alarm, the ways of TB detection, diagnostics and differential diagnostics of pulmonary and extra-pulmonary TB. Moreover, there is an educational promotion of deontology and medical ethics questions to students and listeners of the Advance Training Faculty and the Post-graduate Professional Education Course. They also participate in review conferences related to causes and ways of prevention medical malpractice cases.