Introduction: The paper presents epidemiological process modeling, with a focus on tuberculosis utilizing multiagent system. Material and methods: This study involves the development of an algorithm that harnesses the potential of artificial intelligence to create a geospatial model that highlights the different pathways of TB transmission. The modeling process itself is characterized by a series of key stages, including initialization of the city, calibration of health parameters, simulation of the working day, propagation of the spread of infection, the evolution of disease trajectories, rigorous statistical calculations and transition to the following day. A comprehensive description of the course of active tuberculosis is presented, following the official hypothesis recommended by the World Health Organization. A comprehensive simulation, illustrating the propagation of tuberculosis in an entirely healthy environment devoid of any preventive or therapeutic measures, is presented. To ascertain the adequacy of the model and its sensitivity to the principal parameters governing the course of tuberculosis, a series of experiments were meticulously conducted, employing three distinct approximations, namely: the basic model, the model incorporating mortality factors, and the comprehensive model, encompassing all relevant aspects. Conclusions: The model ' s results exhibit stability and lack of significant fluctuations. The statistical values obtained for infected, latent, and recovered individuals align well with known medical data, confirming the model ' s adequacy.

The review contains an analysis of the latest research on molecular genetic aspects of the formation of resistance in tuberculosis patients to avoid it during use of modern treatment programs. Objective — to assess the situation with the evolution of resistance of Mycobacteria tuberculosis and the stages of drug resistance development using materials from available databases. Materials and methods. The research has been completed for the period from 2014 to 2024. The next stage with the establishment of a systemic topological and metric computer analysis of the results allowed us to see the most informative sections of the research topic that are clearly associated with the formation mechanisms of drug-resistance in pulmonary tuberculosis. The most complete database of available literary sources was obtained (about 50 out of 502 analyzed arrays). Results and discussion. Ukraine is among the thirty countries with a high burden of tuberculosis with multiple drug resistance (MDR-TB). The main threat to the effectiveness of tuberculosis treatment in Ukraine is late detection of the disease and determining the sensitivity of the pathogen, which is the main prerequisite for prescribing adequate treatment. The situation with MDR-TB in Ukraine remains difficult in the conditions of war against the background of the COVID-19 pandemic. Thus, the total number of such cases for 2023 was 1,955 patients, of which 1,326 were new cases. The number of cases of tuberculosis with extended resistance (XDR-TB) was 228, of which 136 patients were diagnosed for the first time. Conclusions. The question of studying the genetic aspects of the formation of drug resistance of M. tuberculosis with the determination of the role of polymorphic variants of genes encoding xenobiotic metabolism systems in tuberculosis infection remains relevant to understand the mechanisms of interaction in the process of implementing hereditary information at the holistic level of the organism in order to increase the effectiveness of treatment and prevent the formation of resistance.

OBJECTIVE. The purpose of our comprehensive analysis is to assess the prospects for the effects of the interaction between coronavirus disease 2019 (COVID‑19) and tuberculosis (TB) and to strategize the risks of spreading TB infection in a coronavirus pandemic. MATERIALS AND METHODS. Test access to full-text and abstract databases was used. RESULTS AND DISCUSSION. An analysis of the available literature has shown that a 3-month lockdown and a long 10-month recovery worldwide could lead to an additional 6.3 million TB cases and another 1.4 million TB deaths between 2020 and 2025. On average, the detection of TB in Ukraine decreased by 27.4 %, and the incidence of TB among children decreased by 34.5 %. This is an alarming figure because we know very well that within 6 months the number of patients with TB has not decreased, they simply stopped being detected. In addition, COVID‑19 may accelerate the activation of latent TB infection and thus increase the number of active cases. CONCLUSIONS. The overall incidence of TB in 2021 will increase to the level that was last observed between 2013 and 2016. The epidemiological indicators of TB control are expected to deteriorate for at least 5-8 years due to the COVID‑19 pandemic. Long-term results can be strongly affected by the rate of short-term recovery. Priority should be given to all governments, during a pandemic, to ensure the continuity of basic health care, including the implementation of national TB programs.

Інфекція, спричинена вірусом імунодефіциту людини (ВІЛ-інфекція) спричиняє найсильнішу імуносупресію, яку вважають основним чинником ризику розвитку туберкульозу (ТБ). Мета роботи — оцінити клінічні характеристики пацієнтів із коінфекцією ТБ та ВІЛ за рівнем імунодефіциту для розробки рекомендацій щодо поліпшення клінічного ведення пацієнтів. Матеріали та методи. Проведено проспективне вибіркове дослідження з участю 86 пацієнтів із ТБ. Пацієнтів розподілили на дві групи: дослідну (38 випадків ТБ, що розвинувся на тлі синдрому набутого імунодефіциту (СНІД), діагностованого за рівнем CD4⁺-клітин ≤ 200/мкл), і контрольну (48 випадків ТБ із рівнем CD4⁺-клітин ≥ 200/мкл). Результати та обговорення. У дослідженні оцінено вплив тяжкості клітинного імунодефіциту, пов’язаного з ВІЛ-інфекцією, на клінічну еволюцію туберкульозу та кінцевий терапевтичний результат. Установ­лено, що лабораторними показниками, які характеризують туберкульоз при СНІДі, є загальний лейкоцитоз із лімфоцитопенією та еозинофілією, анемія, іноді тромбоцитопенія. Усі хворі на СНІД раніше не отримували антиретровірусної терапії і лише третина пацієнтів — на ранніх стадіях симптоматичної ВІЛ-інфекції. Чинниками ризику захворювання на туберкульоз та СНІД були: проживання в сільській місцевості, низький рівень освіти та психічні розлади, пов’язані з кількома причинами (вживання алкоголю, наркотиків і токсоплазмоз центральної нервової системи). Успіх лікування був низьким, а рівень смертності — високим в обох групах, що свідчить про вплив інших супутніх захворювань. Незважаючи на відмінності в сироваткових рівнях CD4⁺-клітин, рівень ефективності лікування був низьким в обох групах і однаковим у тих, хто продовжував протитуберкульозне лікування (кожен третій). Незначно вищою була смертність у групі хворих на туберкульоз на тлі СНІДу — 9 (23,4 %) проти 9 (18,7 %) випадків на ранніх стадіях ВІЛ, спричинених супутніми захворюваннями, пов’язаними з ВІЛ-інфекцією. Висновки. Комплексне обстеження на ТБ і ВІЛ-інфекцію слід проводити в усіх соціально вразливих групах. Важливе значення мають первинна профілактика та індивідуальний терапевтичний підхід.

Background. A statistical analysis published in the WHO report for 2019 showed that almost 10.0 million people (about 9.0-11.1 million) fell ill with tuberculosis (TB) worldwide in 2018. The purpose of a systematic examination and analysis of the WHO report is to summarize the achievements and study of complex issues in overcoming tuberculosis in the world at the present stage, that need more attention, more scrutiny, or a change in approach to addressing specific challenges towards achieving the strategic global goals for eradicating this infection. Materials and methods. We used test access to such full – text and abstract databases: a single package of the information database EBSCO; the largest abstract and citation database of peer-reviewed literature Scopus; Google Scholar; MEDLINE with Full Text; MEDLINE Complete; Dyna Med Plus; EBSCO eBooks Clinical Collection; Web of Science Core Collection WoS (CC); SCIE (Science Citation Index Expanded); SSCI (Social Science Citation Index); AHCI (Artand Humanities Citation Index). Results and discussion. By geography, most TB cases in 2018 were reported in the WHO regions: Southeast Asia – 44 %, African – 24 % and Western Pacific – 18 %. Lower percentages were recorded in the Eastern Mediterranean (8 %), America (3 %) and Europe (3 %). Eight countries account for two – thirds of the world’s total TB cases: India (27 %), China (9 %), Indonesia (8 %), Philippines (6 %), Pakistan (6 %), Nigeria (4 %), Bangladesh (4 %) and South Africa (3 %). These and 22 other countries on the WHO list of 30 high tuberculosis countries account for 87 % of TB worldwide. Multidrugresistant tuberculosis (MDRTB) continues to be a public health threat worldwide. In 2018, about half a million new cases of rifampicin-resistant tuberculosis were reported (of which 78 % had multidrug-resistant tuberculosis). The three countries with the largest share of the global MRTB burden are India (27 %), China (14%) and the Russian Federation (9 %). Globally, 3.4 % of new cases of tuberculosis and 18% of previously treated cases are tuberculosis with extensively resistance or rifampicin-resistant (MDR/RR-TB), with the highest rates of detection (>50 % in previously detected cases) in the countries of the former Soviet Union. Conclusion. The epidemic situation in TB in the world and Ukraine remains complex and at this stage has certain peculiarities, and the prognosis for its overcoming shortly is rather doubtful. There is a tendency to reduce the incidence of tuberculosis, but several complex and controversial issues have been outlined for the eradication of this infectious disease by WHO’s End TB strategy.