High accuracy diagnostic screening tests for tuberculosis (TB) are required to improve the diagnosis of both active TB and latent Mycobacterium tuberculosis (MTB) infection (LTBI). The novel IGRA LIOFeron®TB/LTBI assay was tested and its accuracy was compared to the QuantiFERON®-TB Gold Plus assay. A total of 389 subjects were enrolled in two cohorts and classified as healthy, active TB or LTBI persons. The blood of all the patients was tested with LIOFeron®TB/LTBI assay, containing MTB alanine dehydrogenase, able to differentiate active TB from LTBI diagnosis. The results obtained with both IGRAs, performed on the same 250 samples, were finally compared. The two assays demonstrated an excellent concordance of their results with patients' diagnosis of MTB infection. ROC analysis for QuantiFERON®-TB Gold Plus showed sensitivity and specificity respectively of 98% and 97% in diagnosing active TB patients and 85% and 94% in diagnosing LTBI subjects. LIOFeron®TB/LTBI assay showed sensitivity and specificity respectively of 90% and 98% in diagnosing active TB patients and 94% and 97% in diagnosing LTBI subjects. The two IGRAs displayed the same high accuracy in diagnosing MTB infection/TB disease, and LIOFeron®TB/LTBI assay demonstrated higher sensitivity than QuantiFERON®-TB Gold Plus test in LTBI detection.

Цель исследования: выявить социально-демографические и клинико-лабораторные факторы, ассоциированные с рецидивом туберкулеза. Материалы и методы. Проанализированы клинико-лабораторные данные 208 больных туберкулезом легких, находившихся на лечении в Национальном научном центре фтизиопульмонологии Министерства здравоохранения Республики Казахстан. Оценка уровня антиген-специфической продукции IL-2 к антигену AlaDH M. tuberculosis проводилась с использованием тест-платформ Lionex GmbH (Германия) согласно инструкции производителя. Для статистической обработки полученных данных использована программа SPSS 23.0. При оценке значимости различий в сравниваемых группах применен критерий хи-квадрат Пирсона. Логистический регрессионный анализ в двумерной и многомерной моделях проведен для идентификации факторов, ассоциированных с развитием рецидива туберкулеза. Результаты. Многофакторный логистический регрессионный анализ подтвердил, что мужской пол (OR = 2,086, 95%-ный ДИ 1,001-4,350, p = 0,050), лекарственная резистентность (OR = 4,910, 95%-ный ДИ 1,923-12,534, p = 0,001), фиброзно-кавернозная форма туберкулеза (OR = 6,362, 95%-ный ДИ 2,178-18,585, p = 0,001) и низкий уровень сенсибилизированных Т-клеток, отвечающих продукцией IL-2 в ответ на воздействие антигена AlaDH в IGRA in vitro (OR = 2,155, 95%-ный ДИ 1,060-4,379, p = 0,034), были статистически значимо связаны с рецидивом туберкулеза.

Objective: To identify socio-demographic, clinical and laboratory risk factors associated with fibro-cavernous tuberculosis. Material and methods: Clinical and laboratory data of 184 patients with pulmonary tuberculosis who were treated at the National Scientific Center for Phthisiopulmonology of the Ministry of Healthcare of the Republic of Kazakhstan were analyzed. Specific antibodies to the lipoglycan of M.tuberculosis (MBT) were evaluated in an immunochromatographic assay. To assess the significance of differences in groups, the Pearson Chi-Square test was used. To determine factors associated with the fibro-cavernous tuberculosis, а multiple binary logistic regression analysis was carried out. Results: Multivariate logistic regression analysis showed that low BMI (OR=5,719, 95% CI: 2,049–15,965, p=0,001), TB recurrence (OR=3.374, 95% CI: 1,191–9,561, p=0,022), and a negative specific production of antibodies to lipoglycan of M.tuberculosis (MBT) (OR=0,354, 95% CI: 0,126-0,995, p=0,049) were significantly associated with fibro-cavernous tuberculosis. Conclusion: Weight deficiency, high antibodies levels and TB relapse are factors associated with fibro-cavernous tuberculosis.

Objective: To investigate the prevalence of diabetes mellitus in comorbidity structures and its effect on the clinical course in hospitalized COVID-19 patients in south region of Kazakhstan. Material and methods: A retrospective analysis of data from 918 patients with COVID-19 treated at the City Clinical Infectious Diseases Hospital was carried out. Pearson's Chi-square test and Student's t-test were conducted. Results: In Kazakhstan, diabetes mellitus occupies the second position in the structure of comorbidities in patients with COVID-19 with a share of 20%. Diabetes mellitus in patients most often occurs in combination with cardiovascular diseases and arterial hypertension (20.3% and 16.3%, respectively). Combination of diabetes mellitus, arterial hypertension and other diseases was detected in 72.4% of patients. Combination of diabetes mellitus, cardiovascular and other diseases was detected in 32.5%. In diabetes mellitus patients, COVID-19 was more severe, the hospital stay was longer, and patients over 60 years of age suffered. These patients had a combination of diabetes mellitus with arterial hypertension, obesity, and cardiovascular diseases. Hyperglycemia, elevated blood pressure, rapid breathing, and low saturation were more common for these patients. Conclusion: Diabetes mellitus ranks second in the structure of comorbidities in COVID-19 in the south region of Kazakhstan and is characterized by a combination with cardiovascular diseases, arterial hypertension and obesity. In patients with diabetes, COVID-19 is more severe, which affects the length of stay in the hospital, the mortality rate and the need for transfer to the Intensive Care Unit.

This review presents an analysis of current research on the role of epigenetic mechanisms in regulating gene expression, which is fundamental to key functions of innate immunity in tuberculosis. Tuberculosis (TB), caused by Mycobacterium tuberculosis, has a profound and multifaceted impact on human health. It can lead to a decline in quality of life, disability, and mortality, and is also associated with psychosocial challenges. Non-coding RNAs (ncRNAs) are extensively involved in numerous biological processes, including M. tuberculosis infection, and play a crucial role in gene regulation. In this review, we summarise findings on ncRNAs that influence the host’s immune response to M. tuberculosis infection. Our analysis demonstrates that pathogens can exploit interactions between ncRNAs and other biomolecules to evade immune-mediated clearance mechanisms and persist within host cells for extended periods. During the interaction between M. tuberculosis and host macrophages, ncRNA expression levels undergo significant alterations, affecting the regulation of host cell metabolism, inflammatory responses, apoptosis, and autophagy. These findings provide valuable insights that could contribute to the development of novel approaches for the diagnosis and treatment of tuberculosis.

Objective: To study the structure of concomitant pathologies in low birth weight premature newborns with respiratory distress syndrome (RDS). To identify mortality risk factors in these newborns. Materials and methods: Data from 374 premature newborns weighing less than 1500 g and gestational age less than 32 weeks with RDS treated in the intensive care unit were analyzed. Results: Several comorbidities were more common among children with RDS compared to children without RDS. Thus, disseminated intravascular coagulation syndrome (DIC) occurred 2 times, atelectasis 1.3 times, necrotizing enterocolitis (NEC) 2.4 times, and anemia 1.8 times more often among children with RDS compared to those without RDS. In multivariate logistic regression, such factors as 1-3 points on the Apgar scale at 1 minute (OR - 2.478, 95% CI - 1.289-4.764, p = 0.007), 1-3 points on the Apgar scale at 5 minutes ( OR - 3.754, 95% CI - 1.788-7.878, p<0.0001), DIC (OR -4.428, 95% CI -2.206-8.887, p<0.0001), NEC (OR - 4.508, 95% CI - 2.270-8.954, p<0.0001) showed a positive association with death in children with RDS. When assessing the effect of the combination of DIC and NEC on death, it was found that the combination of these two pathologies in children with RDS increases the risk of death by more than 2 times. Thus, the area under the curve (AUC) for DIC was 0.283, for NEC the AUC was 0.335, and for the combination ICE+NEC it was 0.782). Conclusions: The structure of comorbidities in low birth weight infants with RDS differs from that of infants without RDS. Premature infants with RDS were more likely to develop anemia, DIC, atelectasis, and NEC. The presence of comorbidities increases the risk of death in low birth weight infants with RDS. Low Apgar score, DIC syndrome, and NEC can increase the risk of death in low birth weight premature infants with RDS. It is anticipated that the collected data will enhance personalized care for low birth weight, premature infants with multiple health conditions, ultimately reducing mortality rates in this vulnerable patient group.