Introduction . Identification of a tuberculosis patient, detection of all foci formed by him and anti-epidemic work in each focus are one of the most important areas of preventive work of anti-tuberculosis institutions. In the metropolitan metropolis, special attention paid to improving this work, including by creating a system for monitoring foci of tuberculosis infection.

Materials and methods . The information and program implementation of the task of monitoring foci of tuberculosis infection within the framework of the development of the urban system of epidemiological monitoring of tuberculosis is considered. The data of the register of the tuberculosis infection foci monitoring system (TbFM), introduced in 2021 and including information on all 4487 foci, which were worked with during 2021, and information about which was available in the database on 01.01.2022, was analyzed.

Results. The forms for the TbFM developed by a significant modification of the current account card of the examination of the hearth. The software basis of the TbFM is the Medical Database Management System (MDMS) «Barclay-SV» – a flexible software shell developed by GBUZ «MNPC TB control DZM» together with LLC «Elecard-Med». The MDMS ensures the connection of data about the patient who created the focus with information about him in the registers of detection, dispensary observation and control of treatment operating in the tuberculosis monitoring system of the city of Moscow.

A cohort of 1,798 foci registered in 2021 and 1,488 foci registered in previous years, but not closed by January 1, 2021, analyzed. Among the 1,798 foci registered in 2021, 63.6% formed by tuberculosis patients permanently residing in the city, 23.3% – residents of other subjects of the Russian Federation, 11.1% – foreign citizens and 2.0% – homeless persons. 47.2 ± 1.7 (95%CI 43.8–50.6) contact persons per focus were examined in the foci under consideration.

Among 1798 foci registered in 2021, 24 foci of group morbidity registered, where 35 patients were identified in addition to the index patient, 26 of them were detected during the initial examination of the focus, one was in the IV GDN, 5 were detected not simultaneously and not from the IV GDN, and 3 tuberculosis patients arrived at the focus.

The incidence of tuberculosis among contacts from the immediate environment (before the focus became known to the tuberculosis service) was 371 (95% CI 252-526) per 100 thousand close contacts. Under observation, 2 people fell ill in the IV GDN in 2021, according to one of the foci registered in 2020 and 2021, which corresponds to the incidence in the IV GDN equal to 12 (95% CI 1-43) per 100 thousand contacts from the immediate environment.

Conclusions. The city of Moscow has implemented a system for monitoring foci of tuberculosis infection, which, with a compact volume of data recorded and entered into the register, allows analyzing this area of work in a wide range. The monitoring results once again confirmed the particular complexity of the organization of phthisiological care to the population of the metropolis due to the significant migration burden, and showed a significant amount of work carried out in the city with foci of tuberculosis infection and its effectiveness.

The study analyzed the impact of COVID-19 on the structure of mortality in TB patients in Moscow. Information processed on 1605 cases of death of TB patients from various causes, which registered in 2019–2021 on the city, as well as data from two registers of the city’s tuberculosis surveillance system: the register of deaths of TB patients and register of cases of tuberculosis associated with COVID-19.

The analysis showed that in 2019–2021 the total number of deaths from TB patients in Moscow, regardless of the cause of death, continued to decline: in the group of deaths from HIV infection – by 37.3% and those who died from tuberculosis – by 27.3%. All these years, the proportion of deaths from tuberculosis and HIV infection did not differ significantly, accounting for 32–37% of the total number of deaths.

Among TB patients from city residents who died in 2019–2021 not from tuberculosis, the largest proportion was deaths from HIV infection (62.6%, 42.0% and 46.5%, respectively). In 2019, the next nosology after HIV infection, considered as the cause of death, were neoplasms – 9.3%, in 2020 – diseases of the circulatory system – 12.4% and COVID-19 – 9.8%, and in 2021: COVID-19 became the leading cause of death not from TB and not from HIV infection – 18.2%.

In 2019–2020: there was an increase in the number of cases of post-mortem TB detection in relation to the number of new TB cases from 4.0% (3.3–4.8%) to 7.3% (6.3–8.5%), with a further decrease in the indicator in 2021 to 3.7% (3.0–4.5%).

During the years of the pandemic, there was also an increase in the proportion of deaths at home from 13.8% to 15.8%, with a significant decrease in the indicator in 2021 to 10.1%.

Analysis of the data showed a greater vulnerability to death from COVID-19 in patients with tuberculosis associated with HIV infection. Mortality and mortality from COVID-19 for these patients was 39.1 per 1000 patients and 9.9%, respectively, compared with 9.7 per 1000 patients and 4.5%, respectively, for TB patients without HIV infection.

Information on the mortality of TB patients in 2019–2021, obtained by the city’s TB monitoring system, confirmed the effectiveness of the Moscow TB service during this period of the COVID-19 pandemic.

Introduction. Analysis of the incidence of tuberculosis and its results are the basis for planning the activities of anti-tuberculosis dispensaries.

Purpose. Study and analysis of tuberculosis incidence rates for the period from 2018 to 2021 in the Admiralteisky district of St. Petersburg.

Material and methods. Data from registration forms on the incidence of tuberculosis, as well as information from reports on the incidence of tuberculosis in St. Petersburg and the Russian Federation. The analysis used methods for calculating incidence and prevalence, adopted in phthisiology, and a method for assessing the structure of incidence with the calculation of shares.

Results. In contrast to the data for St. Petersburg and the Russian Federation, in the Admiralteysky district of St. Petersburg, there is an increase in the incidence in 2019–2021. At the same time, in 2021, there is a decrease in the prevalence of tuberculosis compared to 2018. Among newly diagnosed patients, there is an increase in the proportion of patients with a positive HIV status and the proportion of female patients.

In order to assess the dynamics of the course of tuberculosis in patients in the late stages HIV infection studied clinical, radiological and laboratory data of 36 patients, taking into account the presence or absence of COVID-19, divided into 2 groups. Tuberculosis in patients with HIV infection, in most cases is generalized character; patients are bacterial excretors with multidrug resistant pathogen. COVID-19 more than half of the patients (55.6%) proceed against the background of intoxication without pathognomonic symptoms; pronounced intoxication syndrome largely due to the severity of the tuberculosis process. Negative dynamics tuberculosis is 2.5 times more likely to occur against the background of COVID-19.

The characteristics of the COVID-19 epidemic process were studied according to the results of a PCR study by RT-PCR and full-genome sequencing of SARS-CoV-2 in Moscow during the year of observation from 30.07.2021 to 01.08.2022, the total volume of studies was 2 951 398. 19 091 samples were selected for subsequent study by full-genome sequencing. The evolutionary dynamics of genetic lines is noted. In the period from 07.2021 to the middle of 01.2022, the delta strain (AY.122) prevailed in Moscow, but from 12.13.2021 the first samples with the omicron strain (BA.1, BA.1.17.2) were found. In a little more than a month, these strains almost completely replaced the strains of the genetic lines (GL) «Delta«. «New» strains consistently replaced the earlier ones: from 13.12.2021 to 10.01.2022, 19 GL strains of omicron BA.1.x were identified. From 10.01.2022, a «Danish» variety of BA appeared in Moscow.2 (»Stealth Omicron«), which began to quickly displace the rest of the chapters. According to the DCLI, the sixth (since the summer of 2022) wave of infection spread is mainly determined by the «South African» strains of SARS-CoV-2 – variants of VA.4 and VA.5, which were first identified starting from 19.06.2022. The analysis of the prevalence and population composition of 1793 samples with SARS-CoV-2 for the period from 19.06. to 21.07.2022, GL BA.4.x, BA.5.x, VE.x, FF.x infected 1481 patients (82.6%). The pool of infected patients formed by the «early» generations totaled 312 patients.

During the year of observation, 13 cases of re–infection were established: 9 of them were infected with delta strains at the first disease and omicron strains at the second. Infection of two patients was also confirmed, in which in both cases COVID-19 disease was caused by «new» omicron strains.