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The objective of the study: to assess changes in the incidence and prevalence of multiple drug resistant tuberculosis (MDR TB) and TB/HIV coinfection (TB/HIV) in Volga Federal District (VFD) and its regions during 2016-2020.Subjects and Methods. Data from FGSN Forms No. 8, 33, and 61, and analytical reviews of main statistical TB rates in the Russian Federation have been studied. The number of those died is presented as per the Rosstat data.Results. An increase in the incidence and prevalence of MDR TB and TB/HIV coinfection has been detected in certain region of Volga Federal District. Perm Region, the Republic of Bashkortostan, the Republic of Udmurtia, and Orenburg and Samara Regions have the highest prevalence of MDR TB and TB/HIV coinfection. In 2020, the Republic of Bashkortostan was the only region where the incidence and prevalence of MDR TB were growing (164.7% and 47.3%, respectively). The highest incidence and prevalence of TB/HIV coinfection was reported in the Republic of Bashkortostan, Perm Kray, Orenburg Region, the Chuvash and Udmurt Republics. Over the last 5 years, the maximum increase in TB/HIV incidence and prevalence was observed in the Republic of Bashkortostan (38.8% and 41.3%, respectively).

The objective: to determine the state and prospects of TB control services including the period during the COVID-19 pandemic.Materials. Data from Federal Statistic Surveillance Forms no. 4, 8, 14, 14-DS, 30, 33, 47, and 61 were analyzed. The number of those died is presented as per the data of Rosstat.Research methods: epidemiological and statistical analysis, expert assessment, and content analysis of publications and regulations.Results. In Russia in the second decade of the XXI century, there was a significant improvement of tuberculosis situation. From 2010 to 2019, the reduction of the rates was the following: incidence – from 77.2 to 41.2 per 100,000 population (by 46.6%); prevalence – from 177.5 to 86.4 per 100,000 population (by 51.3%); mortality – from 15.4 to 5.1 per 100,000 population (3-fold reduction).In recent years, one can anticipate the stabilization of HIV situation. Over 10 years (2006-2015), the average growth rate of indicators was the following: incidence – by 9.8%, prevalence at the end of the year – by 9.4%, mortality – by 26.6%. In 2016-2019, HIV incidence became stable (2019 – 54.6 per 100,000 population). In 2019, for the first time HIV mortality decreased by 2.1% and reached 13.7 per 100,000 population. The number of lethal TB/HIV co-infection cases is going down. People at the age of 15-34 fall ill (2019 – 37.6%) and die (23.6%) less often versus all new cases and those who died of HIV infection. Russia has the highest coverage of the population with HIV tests (28.5%).Epidemics of tuberculosis and coronavirus infection are developing in the opposite directions. High rates of COVID-19 are observed in regions with low tuberculosis rates, therefore the COVID-19 pandemic will not result in the increase of tuberculosis incidence in the population that is predominantly not infected with tuberculosis. Conversely, in regions with a high level of tuberculosis infection in the population, the number of coronavirus cases is significantly lower.In Russia, in the near future COVID-19 will not contribute to the increase in incidence and mortality of tuberculosis and HIV infection. The negative effects of the pandemic are partially offset by a sharp reduction in contacts, an increase in lung computed tomography, regular supply of anti-tuberculosis and antiretroviral drugs purchased by the state budgets of different levels, improved patients’ adherence to treatment, and the expansion of hospital-replacing technologies in specialized medical organizations.Facilities, resources and personnel of medical TB control services make it possible to expand their functions to fulfill the goals and objectives of the RF Healthcare Development Strategy for the period up to 2025 for socially significant infectious diseases that pose a biological threat to the population (tuberculosis, HIV infections, and parenteral viral hepatitis).

The objective: to describe the current state of tuberculosis situation before the start of the national healthcare project which is to be implemented till 2024. Materials. The data from Federal Statistics Forms no. 8, 33, and 61. The number of those died is presented as per the data of Rosstat. Epidemiological rates were calculated as per mi d-y ear population. Results. In Russia, tuberculosis situation has stabilized and there is a tendency for its improvement, and the changes in main tuberculosis rates provide the evidence of the above. For 10 years (from 2008 to 2017) the following main tuberculosis rates went down: tuberculosis incidence – from 85.1 to 48.3 per 100,000 pop. (by 43.2%); tuberculosis incidence among children from 0 to 14 years old – from 15.3 to 9.7 per 100,000 pop. (by 36.6%); tuberculosis prevalence by the end of the year – from 190.7 to 109.8 per 100,000 pop. (by 42.4%); bacillary excretion in tuberculosis patients – from 80.3 to 46.0 per 100,000 pop. (by 42.7%); tuberculosis mortality – from 17.9 to 6.5 per 100,000 pop. (by 63.7%). In 2017, tuberculosis incidence among resident population, HIV negative (33.4), was lower than the minimum rate, which was registered in Russia in 1991, when HIV infection provided no significant impact on tuberculosis situation in the country (34.0 per 100.000 pop.). in 2017, tuberculosis mortality (6.5 per 100,000 pop.) which hardly now includes those HIV infected and died of tuberculosis, is lower than the minimum rate documented in 1989 (7.4 per 100,000). In the long view, the developing HIV epidemics will provide a negative impact on tuberculosis situation given the growing rates of the patients at the advanced stages of HIV infection and the increasing number of patients with multiple drug resistance. HIV infection will not allow achieving a significant reduction of tuberculosis incidence and will result in the growing fatality among tuberculosis patients in the number of the regions of the Russian Federation. Currently, it is not necessary to concentrate on the number of those examined but to improve the quality of screening in the groups facing a high risk to develop tuberculosis and to consider r e-o rganization of tuberculosis services due to the reduction of tuberculosis incidence. During 10 years (201 8-2 027), tuberculosis incidence is to be reduced twice. The program for tuberculosis incidence reduction is to be predicted for each region specifically, considering the current tuberculosis situation and the level of tuberculosis detection organization. In parallel, the effective tuberculosis care is to be provided for those HIV infected.

Extrapulmonary tuberculosis still remains a mysterious problem greatky due to significant degree of divergence in definitions. Materials and methods. Extrapulmonary tuberculosis incidence and its structure have been analyzed for Siberian and Far Eastern Federal Districts for the last 10 years – from 2006 to 2015. Results. In 2006 in Siberian and Far Eastern Federal Districts there were 871 patients suffering from isolated extrapulmonary tuberculosis, the structure of the forms was as follows: tuberculosis of central nervous system (CNS) – 5.7%; bone and joint tuberculosis – 28.7%; urogenital tuberculosis – 35.9%; tuberculosis of peripheral lymph nodes – 15.8%; ocular tuberculosis – 5.2%, other forms – 8.7%. Starting from 2008 ocular tuberculosis was excluded from reporting, despite the fact that the number of such patients was almost the same as the number of CNS tuberculosis cases. 10 years later in 2015 isolated forms of tuberculosis were diagnosed in 699 (-172) people, forms were the following: CNS tuberculosis – 10.6%, double increase; bone and joint tuberculosis – 39.8%, 1.5 fold increase; urogenital tuberculosis – 24.5%, 1.5 fold decrease respectively. Number of those suffering from tuberculosis of peripheral lymph nodes remained the same – 14.2%, other forms inclusive tuberculosis of salivary glands, pancreas, gall bladder, intestine, breast, skin etc. increased respectively up to 11%. Conclusions. The problem of extrapulmonary tuberculosis in Russia as in the whole world still needs to be resolved. Extrapulmonary tuberculosis incidence greatly depends on the number of properly trained specialists and sufficient technical facilities of dispensaries. The following changes are to be made to Form 8: firstly, urological and genital tuberculosis cases are to be recorded separately; secondly, all forms are to be recorded separately according to HIV status.

Despite that the turning point was achieved in tuberculosis control in the world, still there is on-going interest to this social disease. Goal: to evaluate changes of main epidemiological rates, to publish achievements and prospects of the implementation of National tuberculosis control programme for the period after 2015. Materials and methods. Comparative analysis included evolution of tuberculosis in various localizations in 2011-2015. Results. Tuberculosis situation has been gradually improving in the Republic of Moldova for the last 5 years. The data evidence about the number of tuberculosis cases going down but the global burden of the disease remains fairly high. The success in tuberculosis control supported by WHO and other international organizations is also related to certain Moldavian research achievements. Conclusion. Due to diversity of clinical forms of tuberculosis and the growing problem of comorbidity the cross-disciplinary approach to tuberculosis control can assure success of these activities.