Introduction. In the context of a decrease in the intensity of the epidemic situation of tuberculosis In Russia, the search for new ways to increase the effectiveness of preventive measures to combat tuberculosis among the adult population remains relevant. Aim. To study the prevalence of latent tuberculosis infection in adult tuberculosis risk groups, and to conduct a comparative assessment of the effectiveness of detecting active tuberculosis by immunodiagnostics and fluorography among adults at risk of tuberculosis. Mat erials and methods. In a retrospective study, the results of a survey of people at risk of developing tuberculosis over the age of 18 with a positive test result from ATR-test were analyzed. At the first stage, the prevalence of latent tuberculosis infection was studied. At the second stage, a comparative analysis of the detectability of active tuberculosis during immunodiagnostics and during preventive fluorographic studies was carried out. Results. It was found that among adults at risk of tuberculosis, the prevalence of latent tuberculosis infection in the medical risk group was 2.7 times higher, and in the social risk group it was 8.7 times higher than the average in the population. The detection rate of active tuberculosis according to the results of immunodiagnostics was the highest in the social risk group – 3.8 cases per 1,000 examined. In terms of the effectiveness of tuberculosis detection in adults at risk of tuberculosis, immunodiagnostics is comparable to fluorographic studies (0.19 and 0.17 per 1,000 at-risk subjects, respectively). Conclusions. Conducting annual immunodiagnostics among adults at risk of tuberculosis allows timely detection of latent tuberculosis infection, and also increases the effectiveness of early detection of active tuberculosis, which helps reduce the reservoir of tuberculosis infection.

Objective : to evaluate the efficacy and safety of a rifapentine-containing regimen in treatment of patients with drug-susceptible respiratory tuberculosis and gastrointestinal comorbidities, compared to the standard 6-8 month regimen. Materials and Methods . An analysis of treatment efficacy and safety was performed in 204 patients with drug-susceptible respiratory tuberculosis who completed a full course of therapy. Inclusion criteria: male and female patients aged 18 years and older, newly diagnosed with respiratory tuberculosis with preserved susceptibility of Mycobacterium tuberculosis to the first line drugs, and concomitant gastrointestinal diseases. Exclusion criteria: HIV infection, acute liver diseases of various etiologies, decompensated liver cirrhosis, grade II–III pulmonary heart failure, and chronic renal failure. Patients in the main group (MG, n=77) received a modified chemotherapy regimen for drug-susceptible tuberculosis, where rifapentine replaced rifampicin in both the intensive and continuation phases. The comparison group (CG, n= 127) received standard chemotherapy regimens. Results . By the end of month 4, sputum culture conversion was achieved in 77.8% of patients in the main group and 46.5% of patients in the comparison group. Lung cavity scarring within 6 months of chemotherapy was observed in 84.4% of patients in the main group, versus 51.5% in the comparison group. Adverse events were reported in 2.6% of patients in the main group and 14.2% in the comparison group (p < 0.05). Conclusion . A modified rifapentine-containing regimen for treatment of drug susceptible tuberculosis is effective and safe in patients with gastrointestinal comorbidities.