Тhe study of basic epidemiological indicators of tuberculosis (TB) in children and adolescents in Russia was carried out; the characteristics of the activity and its effectiveness among TB risk groups were presented. It demonstrated the first results of the implementation of methodology for the TB identification in children with the use of innovative technologies in accordance with the Order of the Ministry of Health of the Russian Federation № 855.
The new problems of phthisiology, dealt with Mycobacterium tuberculosis multi-drug resistance in children with TB and the need for changes approaches both to prevention in risk groups, and to the treatment of TB patients were identified. The importance of HIV infection and TB comorbidity in children and the need for continued research on these issues was stressed.

The sharp rise in the incidence of tuberculosis (TB) in children of an early age in Moscow, which occurred after 2010 on the background of TB epidemiological situation improving in general, served as the basis for the analysis of this phenomenon causes. The study conducted was based on data from the Moscow electronic registry system for TB monitoring and additional information collected in a specially designed form. For analysis, we used the information collected as part of the registration form № 089/ у-туб and additional information about 106 children with TB, detected in Moscow since 2011 to 2013, at the age of no more than 2 years 11 months 29 days by the time of registration in the anti-tuberculosis institutions. It has been established that the incidence increase is not related to the deterioration of the epidemiological situation, as during the study period in Moscow even a slight decrease in the number of sputum positive patients took place. Socio-hygienic characteristics of the majority of affected children were also stable (and generally fairly good). So, the main reason for the recent incidence increase in children of an early age was the change of technology to identify local TB forms - the introduction of the test with tuberculosis recombinant allergen, followed by examination of children with respiratory computer tomography. Thus, there is the need to develop and implement measures to prevent over-diagnosis of local TB forms in children.

Data on 2 108 children and adolescents, forwarded to the Central Medical Control Committee of the Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department, the Subcommittee on Childhood Tuberculosis, by the
Moscow anti-tuberculosis institutions and the general health care network institutions in 2012-2014 were analyzed. Data on 1050 children with positive reactions to the tuberculosis recombinant allergen (TRA), additionally examined by computed tomography (CT) of the chest in suspicion for local forms of intra-thoracic TB, were substantially examined. Only in every fifth child (19.5%) the presence of TB local form was confirmed. The most common errors in interpreting the CT results in the general health care network institutions, which may lead to overdiagnosis of “small» TB forms were identified.

Data on 32 children of an early age, treated for tuberculous meningitis (TBM) since 2000 to 2012 in the TB pediatric department of the Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department were analyzed; there were 1 child at the age of 3 months, 4 children - aged 4-6 months, 6 children – aged 7-9 months, 9 children – aged 10-12 months, 7 children – of 1-2 years old, and 5 children – of 2-3 years old among them.
In the group girls prevailed over boys: 17 (53.1%) vs 15 (46.9%). There were 4 Moscow residents, 13 inhabitants from Moscow Region, 12 non-resident patients, and 3 patients from CIS countries among them.
The main risk factors for TBM in children were detected – the lack of BCG vaccination (62.5%), contact with TB patients (87.5%), socially disadvantaged family, the presence of primary immunodeficiency. It was stated that the standard of TBM diagnosis had to include computed tomography of the brain and of the chest as the most informative method of assessing the external and internal hydrocephalus severity, as well as the state of the lung tissue and hilar lymph nodes.
Treatment of TBM patients was the more effective when the more early it started. It was established, that in case of the hydrocephalus development in TBM, bypass surgery was expedient to use.

Case histories of 560 patients, children aged from 0 to 3 years, received treatment in the Reanimation and Intensive Care Unit of the Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department for the period 2000-2013 had been studied.
In clinical structure of the children prevailed tuberculosis (TB) of hilar lymph nodes − 265 patients (47.3%), in 160 (29.0%) of them the process was complicated by infiltrative atelectasis in segmental and lobar lesions (early and late bronchial and lung failure). Among 69
children (12.3%) with generalized TB forms there were lesions of the central nervous system in 30 patients; in 15 cases TB developed in HIVinfected children (2.7%).
The analysis of the Unit activity allowed confidently state the need to implement measures for active influence the various elements in the TB pathogenesis in the patient contingent. This is possible with the help of intensive care and anesthetic techniques, therapeutic
bronchoscopy, continuous infusion therapy, the use of bypass surgery, ventilation. At the same time, with the delayed start of treatment, the presence of severe immunodeficiency, and other significant medical and biological problems the course of TB in the age group may get unfavorable outcome.

Study on characteristics of the patients of the childhood tuberculosis (TB) hospitals and sanatoriums, determining the need for certain types of rehabilitation and corrective measures, was performed. The interrelation of social, hygienic and social characteristics of patients with an increased TB risk, as well as the need of these children in certain types of rehabilitation and corrective actions was considered.

Problems of vaccine prevention of tuberculosis (TB) in children, perinatally exposed to HIV infection, are especially actual on the background of steady increase in the incidence of HIV/TB co-infection in the adult. In Moscow from 2006 to 2013 in the structure of BCG
vaccination exceptions for medical contraindications the proportion of children with prenatal exposure of HIV infection trends to decline, despite the fact that the absolute number of annual births in women with HIV infection is not reduced.
Data of 105 children aged 0 to 6 years old, born by HIV-infected mothers, observed in the Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Health Department in the period from 2003 to 2012, details of BCG vaccination in this
group of children and its impact on the development of tuberculosis process are examined.
It is found that BCG vaccination is still influenced to a significant reduction in the risk of generalized and complicated TB forms formation in children of an early age. So, the further search of options for wider TB immunization coverage of children with perinatal exposure to HIV seems to be actual.

Two cases of tuberculosis (TB) with multiple locations, following TB infection generalization in children, demonstrated the complexity of both the timely TB diagnosis and its treatment. There was favorable outcome as a result of active TB causal and pathogenetic therapy, adequate surgical treatment, individual application of the care and rehabilitation measures in one case. In the second case, due to the lack of specific anti-tuberculosis therapy, death was registered.