The study analyzed the data of the register of the tuberculosis monitoring system in Moscow on total 3372 cases of death of TB patients from all causes that occurred in the city in 2017-2022, including 1239 deaths from tuberculosis, 1144 deaths from HIV-TB (B20.0/ B20.7) and 989 deaths from other causes.

The relationship between the distribution of causes of death and the group of the population to which the deceased belonged was shown, among which 56.9% were from the resident population, 20.8% of homeless people, 16.0% of residents of other regions of Russia (Moscow nonresidents) and 6.3% of foreigners.

The importance of controlling the mortality of TB patients from other causes was noted, among which, for those who died from the permanent population, Moscow non-residents and foreigners, more than 80% were associated with concomitant diseases, the course of which is aggravated in the presence of tuberculosis.

The most important epidemiological characteristics of cases of death of TB patients are considered - the age and sex structure, the place of death and the status of the patient’s lifetime registration as a TB patient.

Among the dead TB patients, about 75% were men and 53.6% were over 45 years old.

The proportion of deaths outside a tuberculosis or infectious diseases hospitals, totaling 37.0%, largely depended both on the causes of death of TB patients and on the population group: 24.7% – for Moscow non-residents, about 40% – for homeless people, for cases of those who died from other causes, the proportion of these cases was 50% or more, and for those who died from HIV-TB – from 5.8% among Moscow non-residents to 21.9% among foreigners.

In general, the proportion of deaths less than 1 month after registration as a TB patient (including post-mortem detection) was 37.1%, with 30.8% for the permanent population and almost 50% for homeless people and foreigners.

Multivariate analysis showed that dying before registration or less than 1 month after registration as a TB patient was 3.5 times more likely to occur in a non-TB or infectious diseases hospital, and 2.6 times more likely to occur in patients with generalized severe forms of tuberculosis, and 1.5 times in foreigners.

Belonging to the resident population was a «protective» factor in terms of the fact that death will occur earlier than 1 month after registration as a TB patient, that is, the chance of belonging to TB patients from the resident population in this group of deaths is 1.3 times lower compared to homeless people, Moscow non-residents and foreigners.

Having confirmed that there is a generally favorable situation with tuberculosis in the Moscow, it is shown that for its further effective control it is necessary to constantly monitor the mortality of tuberculosis patients from all causes in the context of various population groups residing in the city, with an assessment of the proportion of deaths not in tuberculosis or infectious hospitals and the proportion of those diagnosed posthumously and up to a month after registration as a TB patient

Introduction. Mixed mycobacterial infections are an urgent problem for phthisiology and pulmonology, which has not been studied enough.

The aim of the study was to assess the frequency of detection of mixed populations of mycobacteria in patients with tuberculosis and mycobacteriosis and to determine the species composition of these populations.

Materials and methods. Clinical isolates of mycobacteria isolated from 5531 patients who were treated or who sought advice from the FSBI «TSNIIT» were studied. The culture was isolated in the BACTEC MGIT 960 automatic crop growth registration system, species identification was carried out by molecular genetic methods using the GenoType Mycobacterium CM/AS kit (Hain Livescience, Germany) and/or a set based on multiplex PCR in real time. The conclusion about the presence of a mixed population was made if a mixture of two species of mycobacteria was isolated during the entire observation period or the species structure of the population changed dynamically. Descriptive statistics were used to evaluate the results of the study, the chi-squared criterion was used to determine significant differences between groups; differences were considered statistically significant at p < 0.05. The entire analysis was carried out using Microsoft Excel (Microsoft, USA).

Results. The frequency of detection of mixed mycobacterial infection by culture method in patients of phthisiological institutions for the period 2011-2023 was 1.16%. The most common combinations of species were M. tuberculosis + M. avium and M. avium + M. intracellulare

The article deals with conceptual issues and analysis of the problem of differential diagnosis of various granulomatosis depending on the etiological factor of granuloma, their prevalence in the practice of a phthisiologist, provides an overview of the literature data and own experience of differential diagnosis.

The aim of the study. Study of the structure of various granulomatoses in an antituberculous institution based on the analysis of data registered in the Moscow city phthisiological institution.

Materials and methods. It is based on data on the detection and observation of sarcoidosis, disseminated tuberculosis, mycobacteriosis, pneumonitis, vasculitis for decades on the basis of the head city joint phthisiological institution of Moscow GBUZ «Moscow City Scientific and Practical Center for Tuberculosis Control of the Department of Health of the City of Moscow».

Results. Tuberculosis is an infectious disease, the causative agent of which Mycobacterium tuberculosis (MBT) causes an immune response with the formation of granulomatous inflammation. Granulomatous inflammation is a complex, cell–mediated immune response, the development of which requires the presence of a persistent antigen in macrophages. MBT is the most common, but not the only such antigen. Epithelioid cell granulomas develop in tuberculosis, sarcoidosis, mycobacteriosis, vasculitis, mycoses, pneumoconiosis, alveolitis and in some cases are identical in all diseases, with the same mechanism of transformation of macrophages into epithelioid cells and Pirogov–Langhans cells and the mechanism of granuloma formation. Depending on the etiological factor, granulomas may have certain structural features and involutions that can only be identified by examining a sufficient amount of morphological material. In this regard, in practice, the diagnosis of granulomatosis is traditionally a difficult task. One of the most important competitors of tuberculosis, as granulomatosis, is sarcoidosis. The results of unofficial statistics of sarcoidosis in Moscow for 1961-2019 on the frequency and structure of clinical forms, course variants, and outcomes considered, the incidence in representative samples by year and the prevalence of sarcoidosis of the respiratory organs in the metropolis are determined. The analysis of epidemiological indicators on disseminated tuberculosis in Moscow for 2012-2019 presented. Among various groups of the population. The spectrum of the main types of granulomatoses, other than tuberculosis, dropped out of phthisiological clinics in 2010-2020 has been determined.

The data of medical records of 43 HIV-infected pregnant women and 46 children analyzed for the period from 2017 to 2022. The average age of the women was 33 years (33.6 ± 0.89). Many women (86.0%) had sexual transmission of HIV. The duration of HIV infection in more than half cases (51.1%) was more than 6 years. HIV/HCV co-infection diagnosed in 27.9% of women. 29 HIV-infected women received rilpivirine/tenofovir/emtricitabine before pregnancy. 14 patients received ART regimens, including 2NRTIs and NNRTIs or Pis, and were switched to rilpivirine/tenofovir/emtricitabine during pregnancy. During pregnancy, CD4⁺ cells increased from 632.2 ± 42.6) cells/mm³ before pregnancy to 702.1 ± 39.7 cells/mm³ after delivery. HIV RNA levels before pregnancy averaged 795.3 ± 468.1 copies/mL and decreased to undetectable during pregnancy and after delivery. There were no cases of the mother-to-child transmission of HIV. The average birth weight of newborns was 3.350 grams (1.300–4.200), and the average height was 53 cm (45–56). During the observation period, the physical and psychomotor development of children corresponded to age norms.

Introduction. Currently, there has been an improvement in the situation of tuberculosis in the Russian Federation. Despite successful preventive and diagnostic measures of phthisiatric service, cases of the disease still occur in adolescence.

Purpose of work. Clinical demonstration of a case of pulmonary tuberculosis in an adolescent with concomitant pathology.

Methods. A clinical case of a 16-year-old boy with infiltrative pulmonary tuberculosis, which developed against the background of a longstanding infection with MBT, presented. The rapid development of pronounced changes in the lungs, decay and infiltration may have been provoked by adolescent age and the presence of concomitant pathology.

Results. Slow clinical and radiological dynamics observed in the course of the disease, but the complex approach to treatment with the use of minimally invasive non-medicinal method of valve bronchoblockage permitted to achieve positive results. Due to their physiological peculiarities, connected with hormonal reorganization of the body, teenagers are a «risk group» for tuberculosis.

Discussion and Conclusion. Tuberculosis process in this age group is characterized by a number of distinctive features which are related to certain reasons, among which are anatomical and physiological peculiarities of teenagers, changes in living conditions, transition from complete social and economic dependence on adults to relative social independence and coexisting diseases. The task of general practitioners and tuberculosis doctors is to organize the early detection of tuberculosis in adolescence and to provide correct and controlled treatment.

BCG is a unique vaccine. It was created and successfully used for specific prevention of tuberculosis. Reactivation of the BCG scar is a transient condition that occurs against the background of various diseases, capable of resolving itself, does not involve surgical intervention, but due to the low frequency of detected cases and the lack of pathogenetic justification for its occurrence requires dynamic observation.