The objective: to assess impact of the COVID-19 restrictive measures on tuberculosis detection among children and adolescents. Subjects and Methods . For the analysis, materials from statistical collections and state statistics forms (Form No. 33) were used. Changes of the main epidemiological tuberculosis rates were assessed for two observation periods: before the pandemic (2017-2019) and during the pandemic (2020-2022). Statistical analysis methods were used. Results. The COVID-19 pandemic and related restrictive measures generally provided no significant impact on the coverage with preventive screening for tuberculosis of population in the Republic of Sakha (Yakutia). At the same time, during the pandemic, a slight reduction of the main epidemiological tuberculosis rates was noted both among adults and children. Despite this decrease, a deterioration in the structure of new tuberculosis patients was revealed, which indicated that the disease was not detected in a timely manner.

This paper presents a clinical case of a favorable tuberculosis chemotherapy outcome in a premature newborn. The role of early diagnosis in the development and outcome of the disease is shown. The newborn had no specific symptoms and clinical signs of tuberculosis. Therefore, when signs of an infectious disease appear in newborns, account should be taken of the mother’s medical history and the results of her fluorographic examination after childbirth. A favorable outcome can be achieved by timely separation of newborns from infected mothers, prompt commencement of specific chemotherapy, and patient management by phthisiatricians, neonatologists, and resuscitators.

The objective : to compare efficacy of preventive treatment of children with latent tuberculosis infection using various regimens of anti-tuberculosis drugs and assess the risk of adverse events to these drugs. Subjects and Methods . 117 children of 2-17 years old with latent tuberculosis infection [a positive result of the test with tuberculous recombinant allergen (TRA)] were enrolled in the prospective study. They received preventive treatment with the regimen containing isoniazid and rifapentine. The comparison group included 84 children who received isoniazid and rifampicin. Results . In terms of safety and efficacy of chemotherapy regimens in the study, the best results were obtained when using the regimen containing isoniazid and rifapentine: the therapy was well tolerated, hepatotoxic reactions were registered in 1.7% of children. After a full course of preventive treatment in 24 months of follow-up, there was a statistically significant decrease in the proportion of hyperergic results of the skit test with TRA from 44 (41.9%) to 0 (0%) χ 2 McNemar 43.00; p < 0.01; and conversion of the TRA test result from positive to negative was observed in 18.1% of children.

Symptoms of COVID-19 in patients with various manifestations of tuberculosis infection do not differ from those of acute respiratory viral infection. The disease proceeds without complications, does not aggravate the course of tuberculosis infection, after three weeks the production of class G immunoglobulins to the SARS-CoV-2 virus is noted.

During the COVID-19 pandemic in the Russian Federation associated with restrictions and quarantine, in order to ensure the quality and availability of tuberculosis medical care to the population of the Republic of Sakha, it became necessary to improve and search for new organizational forms of out-patient care.The objective of the study: to analyze the use of new technologies in out-patient care for tuberculosis patients in the Republic of Sakha (Yakutia) during the COVID-19 pandemic.Result: Scientific Practical Phthisiology Center introduced the following information and digital technologies to ensure the availability and quality of medical services to the population of the republic during the COVID-19 pandemic: Cloud Polyclinic, Telemedical Consultations, Radiological Information System of APK ArchiMed , Video-Controlled Treatment at Home, and Hospital at Home.All technologies have demonstrated their efficacy for remote medical consultations and contacting patients online. Based on practical experience, these technologies provided the following: improvement of medical care provided to the population through consultations, maintaining good contact with the patient, monitoring patients' well-being, and drug in-take. They assured compliance with general federal and regional anti-epidemic recommendations to prevent the spread of the new coronavirus infection.

The objective of the study: to assess the efficacy of standard chemotherapy regimens in the treatment of children and adolescents suffering from respiratory tuberculosis.Subjects and methods. 272 children aged 0 to 17 years old with newly diagnosed respiratory tuberculosis were on treatment.Results. Treatment of children suffering from respiratory tuberculosis with standard chemotherapy regimens made it possible to achieve cure of tuberculosis in 264/272 (97.1%) children and adolescents aged 0-17 years old, 8/272 (2.9%) underwent surgery additionally to chemotherapy.

This article describes a clinical case of hematotoxic adverse reaction in a patient on the background of anti-tuberculosis chemotherapy. It has been established that the appearance of anemia of mixed genesis with thrombocytopenia in a patient is associated with the intake of PASK. PASK instruction indicates the appearance of thrombocytopenia, leukopenia in rare cases. On the background of the replacement therapy with blood components and the cancellation of anti-TB drugs, blood counts returned to normal. The probable degree of reliability of cause-effect relationship by adverse side reaction is established. Currently, the patients condition is satisfactory. The patient feels good. The function of hematopoiesis is restored.

The aim of the study was to determine the prevalence of drug-resistant tuberculosis among children and adolescents in the Republic of Sakha (Yalcutia) (RS(Y)) and the features of its clinical manifestation, in order to improve the prevention and treatment of the disease. We monitored a total of 250 children and adolescents with tuberculosis (TB) who underwent inpatient treatment in the Yakut NPZ in 2012-2016: The patients included 34(13.6%) children in the 0-2 age group, 80(32%) in the 3-6 age group, 74(29.6%) in the 7-14 age group, and 62(24.8%) adolescents between 15 and 17 years. The timing of the development of the disease from the time of primary infection with Mycobacterium tuberculosis differed significantly depending on the age of children. In young children, compared with older children, signs of the disease appeared at an earlier time. In the structure of clinical forms of TB, the differences were observed depending on the age of the children: - In children under 2 years, the lesion of intrathoracic lymph node tuberculosis (ITLN) was most common, as well as generalized TB - For children aged between 3 and 6 years, the lesion of ITLN was characteristic - For older children, the different clinical forms of TB were characteristic. The expression of immunological tests depended on the age of the patients and the number of ITLN lesions. Drug resistance to anti-tuberculosis drugs was found in 21(36.8%) patients; multidrug-resistant TB was mainly registered in adolescents and multidrug resistance was mainly primary. Drug resistance to isoniazid, rifampicin, and streptomycin was the most frequent. Thus, it has been established that the outcome of the disease and the timing of the onset of clinical involution of the disease depend on many factors, including the timeliness of disease detection, the age of the patient, the dissemination of TB process, and others.

Goal of the study: to analyze the tendencies in tuberculosis situation among children in Sakha Republic (Yakutia) for the last ten years when some new diagnostic tools have been introduced.Materials and methods. The analysis included data of official statistic reporting on tuberculosis (Form no. 33) among children in Sakha Republic (Yakutia) from 2005 to 2014. During this period of time tuberculosis was newly diagnosed in 647 children in the age from 0 to 14 years old. Their ethnicity, age, tuberculosis detection methods, clinical forms, frequency of bacillary excretion and types of complications were studied.Results. In 2005-2009 in Sakha Republic (Yakutia) the part of children among all new tuberculosis cases made 11.2% and in 2010-2014 it reduced down to 8.2%. The number of children who developed tuberculosis reduced by 51.5% in 2014 versus 2005 (2014 – 51, 2005 – 105 cases). Among new tuberculosis cases in children the exposure to tuberculosis was identified in 57.9% (2005-2009) and in 73.9% (2010-2014), which provided the evidence of severe burden of tuberculosis in the Republic. The part of children in age from 0 to 2 years old made 20.8% in 2005-2009 and 20.4% in 2010-2014. Children in the age from 7 to 14 years old developed tuberculosis the most often. In 2005-2009 tuberculosis was detected in children mostly by tuberculin tests (70.4%) and in 2010-2014 during examination after exposure to a tuberculosis case (43.6%) and less frequently by tuberculin tests (40.2%).

Goal: analysis of X ray diagnostics of tuberculosis in children staying in the specialized sanatorium in 2010-2015. Results. Every year from 19.1 to 66.7% of children suffering from active tuberculosis in Sakha Republic are detected through computer tomography in the specialized sanatorium for children.

Analysis of nutrition management of children infected with Mycobacterium tuberculosis, being treated in the children's sanatoria of the Republic Sakha (Yakutia) was done. Data reporting on patients' nutrition management were analyzed, 640 menu-layouts derived from 9 regional children's tuberculosis sanatoria for 2011-2012 were studied. In the children's sanatoria of Sakha (Yakutia) Republic discrepancies to RAMS Institute of Nutrition recommended standards of consumption of basic foods, calorie, protein, fat and carbohydrates were established.

Results of monitoring for complications to BCG vaccine in children in Sakha Republic (Yakutia) are presented. Incidence and nature of complications to vaccines against tuberculosis infection and the clinical structure of complications were analyzed; causes of complications were determined. For the last years, we observed growing incidence of complications to vaccines against tuberculosis. The study established that complications develop most often to BCG vaccine, and rarer to BCG-M vaccine. Lymphadenitis was the prevailing diagnosis in the clinical structure of complications. Severe forms of complications were registered more frequently in children under 3 years of age. Complications in children immunized at pediatric polyclinics or rural first aid posts were mostly due to wrong administration technique. Main causes for complication development were: perinatal pathology, underestimation of counterindications, infectious or virus diseases in postvaccinal period, faults in vaccine administration technique.

The results of implementation in the Republic Sakha (Yakutia) of the new approaches in the organization of sanatorium for children from risk groups for tuberculosis are presented.The efficiency of organizational and methodological work carried by Republican Children's Tuberculosis Sanatorium after T. P. Dmitrieva with district children's tuberculosis sanatoria is analyzed. Results of the work to strengthen the sanatorium's material base, training and retraining of medical personnel and teachers, educators, the rational use of sanatorium beds are shown. The positive impact of new approaches to management of tuberculosis care for children in specialized sanatoria in the incidence of tuberculosis among children in the Republic of Sakha (Yakutia) is established.

The variability of polymorphic variants of three interleukine genes (rs1143634 in the gene IL1B, rs3212227 in IL12B gene and rs2234663 in the gene IL1RN) in Yakuts is characterized. Associations of studied polymorphic variants with pulmonary tuberculosis in Yakuts are not revealed. A comparison of allele and genotype frequencies between groups of TB patients and between control groups of three ethnoses (Russians, Tuvinians and Yakuts) of Siberia is held. It was shown that the differences between the samples of patients from different ethnic groups were of different nature (variability of allele frequencies and genotypes) than at comparing population samples. These differences in the level of differentiation between groups of patients and control of different ethnicities suggest the existence of racial specificity of the frequency distribution of alleles and genotypes of the investigated genes-candidates of susceptibility to tuberculosis.

A comprehensive study has determined the incidence of infection with multidrug-resistant (MDR) Mycobacterium tuberculosis (MBT) strains in children. It has first revealed the clinical and laboratory manifestations and specific features of an immune system response in children infected with MDR MBT strains. There is new evidence that impaired immunological responsiveness is similar in children infected with drug-resistant MBT strains and in those with drug-resistant tuberculosis. A rationale is provided for the use of preventive treatment with two antibacterial agents in combination with the immunomodulator licopid to prevent tuberculosis in children with drug-resistance of MBT.