Treatment Of Tuberculosis Patients Research Articles

Long-term Survival of Treated Tuberculosis Patients in Comparison to a General Population In South India: A Matched Cohort Study

ObjectivesThis study aimed to measure the mortality rate, potential years of life lost, and excess general mortality among individuals treated for pulmonary tuberculosis (TB) in a TB endemic country. MethodsA retrospective analysis was conducted on a population-based cohort study of 4022 TB patients and 12,243 gender-matched and age-matched controls from prevalence surveys conducted between 2000 and 2004 in the Thiruvallur district of Tamil Nadu, South India. ResultsThe mortality rate among TB patients was 59/1000 person-years. The excess standardized mortality ratio was 2.3 (95% CI: 1.7–3.1). The rate of potential years of life lost was 6.15/1000 (95% CI: 5.97–6.33) in the TB cohort compared to the general population of 1.52/1000 (95% CI: 1.46–1.60). Individuals aged >50 years, those underweight (<40 kg), with treatment failures, or lost to follow-up had higher mortality rates when compared with the rest of the TB cohort. The risk of death was significantly higher in the TB cohort until the end of the fourth year when compared with later years. ConclusionMortality in the TB cohort was 2.3 times higher than in the age-matched general population. Most deaths occurred in the first year after completing treatment. Post-treatment follow-ups and interventions for reducing comorbid conditions are necessary to prevent deaths.

On traumatic pneumothorax with primary gas injection

Over the last 10-15 years, treatment of tuberculosis patients with artificial pneumothorax has become widespread and there are many works devoted to collapse therapy in the press; details of the technique, efficiency of treatment, and complications are discussed. Spontaneous pneumothorax (SP) is one of the most dangerous complications of pneumothorax. Under p. p. we understand gas accumulation in pleural cavity in case of lung perforation, as the result of pathological process in the lung, more often of subpleural cavernous cavity breakthrough, caseous focus, or due to lung parenchyma needle trauma while applying pneumothorax.

Effect of Case Management Nursing Service on Compliance Behavior and Quality of Life of Patients with Pulmonary Tuberculosis

Objective: To explore the effect of case management nursing service on compliance behavior and quality of life of patients with pulmonary tuberculosis. Methods: 69 cases of pulmonary tuberculosis patients in our hospital from September 2019 to August 2020 were selected as the research objects. The 69 patients were divided into study group (35 cases) and control group (34 cases). The compliance behavior, quality of life and nursing satisfaction of pulmonary tuberculosis patients were studied and analyzed. Results: The compliance rate of the control group was 82.35%, and that of the study group was 97.14%;The quality of life in the control group was [61.32 ± 7.66], which was significantly lower than that in the study group [71.12 ± 7.23];The satisfaction rate of the study group was 97.14%, which was significantly higher than 73.53% of the control group. Conclusion: In the treatment of tuberculosis patients, the use of case management nursing service can effectively improve the quality of life of patients, improve the compliance behavior of patients, and improve the treatment effect of patients, which is worthy of promotion.

Malnutrition and tuberculosis: the gap between basic research and clinical trials.

Mycobacterium tuberculosis (M.tb) is the causative agent of tuberculosis (TB), an infectious disease that leads to numerous deaths worldwide. Malnutrition, smoking, alcohol abuse, Human Immunodeficiency Virus infection, and diabetes are some of the most important risk factors associated with TB development. At present, it is necessary to conduct studies on risk factors to establish new effective strategies and combat this disease. Malnutrition has been established as a risk factor since several years ago; although there is in vitro experimental evidence that reveals the importance of micronutrients in activating the immune response against M.tb, evidence from clinical trials is controversial. Currently, nutritional assessment is recommended in all TB patients upon diagnosis. However, there is insufficient evidence to indicate micronutrient supplementation as adjuvant therapy or prophylactic to prevent micronutrient depletion. Strengthening the interaction between basic and clinical research is necessary to carry out studies that will help establish adjuvant therapies to improve outcomes in TB patients. In this review, we discuss the experimental evidence, provided by basic research, regarding micronutrients in the TB field. However, when these studies are applied to clinical trials, the data are inconsistent, indicating that still missing mechanisms are necessary to propose alternatives to the treatment of TB patients.

Nutritional Status of Tuberculosis Patients in Against Serum Glutamate Pyruvate Transaminase Levels

Background: Treatment of Tuberculosis patients are given in the form of a drugs combination. Some drugs which are Pyrazinamide, Isoniazid and Rifampicin can provide hepatotoxic side effects. Specific sign of hepatotoxic occurrence is increasing in the Serum Glutamate Pyruvate Transaminase levels. One of factors that influence hepatotoxicity is nutritional status. This study aims to determine the relationship between nutritional status and levels of Serum Glutamate Pyruvate Transaminase in tuberculosis patients.Methods: A non-experimental correlation study, retrospective approach with total sampling method, according to inclusion and exclusion criteria. Located at tCommunity Lung Health Center (BKPM) Ambarawa area. The analysis used the Spearman rank correlation testResults: Based on the test results of Spearman Rank correlation test, the correlation coefficient (r) is -0.267. Hypothesis test results also showed 0.037 (p-value &lt;0.05), which means the existence of a significant correlation between variabels.Conclusion: There is a relationship between nutritional status and levels of Serum Glutamate Pyruvate Transaminase in tuberculosis patients.

Factors affecting outcome of longer regimen multidrug-resistant tuberculosis treatment in West Java Indonesia: A retrospective cohort study.

BackgroundMultidrug-resistant tuberculosis had high treatment failure and mortality. Success rate of treatment currently 56% at global level, 48% in Indonesia and 36% in West Java province, the most populated province and surround Jakarta, the capitol of Indonesia.ObjectiveThis study aimed to evaluate factors affecting success of multidrug-resistant tuberculosis treatment in patients using longer treatment regimen in West Java Indonesia.MethodsThis was a retrospective cohort study of multidrug-resistant tuberculosis patients treated with longer regimen at Hasan Sadikin General Hospital from January 2015 to December 2017. Potential risk factors associated with the treatment outcome were analyzed using multiple logistic regression.ResultsA total of 492 patients were enrolled during the study period. Fifty percents multidrug-resistant tuberculosis patients had successful treatment outcome. Age ≤45 years, male, normal body mass index, no previous tuberculosis treatment, culture conversion ≤2 months, acid fast bacilli sputum smear ≤+1 were independent factors associated with increased treatment success. Sputum culture conversion ≤2 months was the major factor affecting successful outcome (RR 2.79; 95% CI: 1.61–4.84; p-value<0.001). Human Immunodeficiency Virus infection, chronic kidney disease, and cavitary lesion were independent risk factors for unfavourable outcome.ConclusionAge, gender, body mass index, tuberculosis treatment history, time of sputum conversion, acid fast bacilli sputum smear, HIV infection, chronic kidney disease, and cavitary lesion can be used as predictors for longer multidrug-resistant tuberculosis treatment regimen outcome.

The Effect of Side Effects Tuberculosis Treatment in the Early Stage Towards Compliance with Tuberculosis Patients

Pulmonary tuberculosis treatment causes various side effects including nausea and vomiting, itching, vision problems, and anemia. Drug side effects in the early stages are one of the causes of non-adherence to complete treatment. The purpose of this study was to analyze the effect of the side effects Tuberculosis treatment in the early stages on treatment compliance for tuberculosis patients. This study used a cross sectional design. Samples were taken as many as 71 respondents, the instruments used were side effects of early-stage tuberculosis treatment and compliance with tuberculosis treatment in tuberculosis patients from the Morisky Medication Adherence Scale (MMAS). The results of the study found 97.7% adherent and 2.3% non-adherent, 39.5% mild side effects and 60.5% severe side effects. Chi-square test showed that no significant difference between the side effects of TB treatment in the early stages of tuberculosis treatment compliance in patients p = 0.669 at significant level of 95% (α = 0.05). There was no effect between the side effects of Tuberculosis treatment in the early stages of treatment compliance for Tuberculosis patients. It was recommended that health workers continue to monitor the side effects of tuberculosis treatment and provide motivation to carry out treatment completely.&#x0D; &#x0D; Keywords: side effects; early stage; treatment; pulmonary tuberculosis; compliance

Мезенхимные стволовые клетки в терапии туберкулеза

Tuberculosis, caused by the obligate intracellular microorganism Mycobacterium tuberculosis, is one of the oldest known infectious diseases in humans. Modern therapy of tuberculosis, consisting of several antibacterial drugs, is long-term, toxic and requires high compliance from the patient, therefore, the development of new therapeutic strategies that would minimize the duration of treatment and prevent the formation of drug-resistant forms of mycobacteria is relevant and important. Cellular therapy now holds the promise of potential complementary therapeutic options for the treatment of drug-resistant tuberculosis. In recent years, the possibilities of using mesenchymal stem cells in the treatment of tuberculosis of various localization have been widely studied. The use of such cells in conjunction with standard anti-tuberculosis therapy holds great promise for shortening the duration of treatment and reducing the formation of drug-resistant mycobacteria. This article describes the possibilities of using mesenchymal stem cells in the treatment of tuberculosis in patients, including those with extensive and multidrug resistance, as well as the mechanisms of interaction of mesenchymal stem cells with M. tuberculosis.

Health System Delay in the Treatment of Tuberculosis Patients in Ethiopia: A Systematic Review and Meta-analysis

Delay in diagnosis and initiation of effective treatment associated with an increase in morbidity, mortality, and ongoing person-to-person transmission in the community at large. Several studies have been conducted in Ethiopia; however, studies assessing the health system's delay in treating tuberculosis patients have yielded inconsistent and inconclusive results. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. We systematically searched different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus, and Springer link databases for studies published from June 6,1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using a random-effects model in R version 4.0.3 software (for median estimation) and Stata version 14 (for metan). A total of 14 studies with 6161 patients who met predetermined criteria were included. Our meta-analysis showed that the estimated pooled median time of the health system delay was 15.29 (95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015, the pooled median health system delay was 21.63 (95% CI: 14.38-28.88) days, whereas in studies conducted after 2015, the pooled median time was 9.33 (95% CI: 3.95-14.70) days. Living in rural areas (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. In Ethiopia, this review highlights that patients were delayed more than two weeks in the treatment of tuberculosis. Being a rural resident, was the contributing factor of health system delay. For successful TB control, implementing efforts like providing regular health education to the community about TB emphasizes the rural community and enhancing the quality of care in TB treatment facilities in rural areas could have important implications to reduce health system delay.

Treatment outcome in smear-positive pulmonary tuberculosis patients treated with a fixed-dose drug combination regimen in comparison with a separate regimen

Context The number of tuberculosis (TB) patients and multidrug-resistant species of Mycobacterium tuberculosis are increasing worldwide. Effective treatment is still the key factor to control TB in the society. Aims The aim of the study was to compare the efficacy of fixed-dose combination (FDC) and separate drug (SD) in the treatment of TB. Settings and design The study was a randomized, clinical trial carried out on 331 smear-positive TB patients in the Golestan province, Iran. Patients and methods Diagnosis and monitoring method was direct observation of sputum smears under a light microscope, which was used at the end of the second, third, fourth, fifth, or sixth months during the treatment. Statistical analysis used Sputum smear conversion rate at the end of second months and therapy outcome at the end of the treatment period were compared in both groups of the study by using the Poisson regression model and calculation incidence rate ratio. Results Sputum smear conversion rate at the end of the second month of the treatment had no significant difference between two groups. Success rate at the end of the treatment period was 89.36% in the intervention group and 95.65% in the nonintervention group which had significant difference (P=0.03). Adverse event incidence rate was 5.44% in all studied cases during the period of treatment. It had significant difference between the group who received FDC (8.93%) and the other who received SD (1.86%). Conclusion SD had better efficacy than FDC drugs in the treatment of TB patients.

Perceived Barriers of Tuberculosis Case Notification among Private Practitioners in Central Karnataka

Background: India is the highest tuberculosis (TB) burden country in the world accounting for almost one-fourth of the global cases and deaths as per the global TB report 2021. There are evidences suggesting that private practitioners (PPs) in India are not equipped with sufficient knowledge to carry out proper management of TB patients and certain barriers in TB case notification. So the present study is under taken to explore the perceived barriers for TB case notification from private practitioners.&#x0D; Methodology: In-depth interview, qualitative research was done with the PPs who diagnosed and treated TB patients in 2018 but not notified to district TB centre. PPs were selected for in-depth interview by simple random sampling method. In-depth interview were stopped based on the saturation of data. Study was conducted from July-December 2018.&#x0D; Results: In-depth interview were conducted with 28 private practitioners. Perceived barriers for notification of TB cases by private practitioners were few misconceptions, patient’s confidentiality and stigma, lack of co-ordination between public and private sector and lack of simplified mechanism for TB notification.&#x0D; Conclusion: Private practitioners are the main stake holders in moving the country toward TB elimination so addressing their challenges is the need of the hour. Trust building and reorientation of private practitioners will address the major misconceptions about the TB case notification.

The first experience in the surgical treatment of pulmonary tuberculosis in patients who have experienced COVID-19

The first experience in the surgical treatment of pulmonary tuberculosis in patients who have experienced COVID-19

Drug-Resistant Mycobacterium tuberculosis Isolates from New and Previously Treated TB Patients in China, 2017-2019.

INTRODUCTION: Mycobacterium tuberculosis (MTB) is a causative agent of tuberculosis (TB) that causes death worldwide. METHODS: MTB was subjected to phenotypic drug-susceptibility tests (DST), and drug-resistant genes were sequenced. RESULTS: Previously treated patients were more likely to have positive smear results and exhibit drug resistance. New patients were more likely to be mono SM-resistant and less likely to be INH- and RIF-resistant. The most common mutations were katG (S315T), rpoB (S450L), rpsL (K43R), and embB (M306V). CONCLUSIONS: The proportion of mono-SM-resistant TB among new patients was higher.

Impact of Uncontrolled HbA1C on The Outcome of Tuberculosis Treatment in TB Patients With Diabetes

Pulmonary tuberculosis (TB) is an infection and communicable disease caused by Mycobacterium tuberculosis. One of the risks to develop active tuberculosis is diabetes mellitus (DM), with two or three times higher than TB patients without DM. Several studies have reported that DM was associated with poor clinical outcomes characterized by a delay of smear sputum conversion or culture conversion in TB patients with DM. However, very limited studies that analyze uncontrolled diabetes by HbA1c level with clinical outcome of TB treatment. This study aims to review the correlation between HbA1c levels and sputum or culture conversion in TB patients with DM. Pubmed, Web of Science, and Embase database were used to search and select the article. We included five studies that met the inclusion criteria. Smear conversion rate at two months was lower in TB patients with DM than those without DM. Uncontrolled HbA1c levels &gt; 6.5%-7.0% were significantly associated with smear conversion of culture conversion for more than two months with a high risk of treatment failure. The positive level of smear sputum at 2-3 months or the end of the intensive phase becomes a strong predictor a failure treatment at the end of the advanced phase. It can be concluded that HbA1c levels delay the smear sputum or culture sputum for more than two months. This review highlights a need for more attention to control HbA1c levels in TB patients with DM to achieve a better outcome.

Severely ill patients with tuberculosis: the option to reduce mortality and optimize management with the help of step therapy and the usage of infusion forms of anti-tuberculosis drugs

Background. A doctor often has to answer the question whether it is sufficient to treat tuberculosis (TB) exclusively with the oral forms of anti-tuberculosis drugs (ATD). In general, the answer is yes, if the absorption of drugs and their delivery to the affected organs is not impaired. However, drug absorption is often impaired due to hypoalbuminemia, TB of the gastrointestinal tract or central nervous system, concomitant diseases of the digestive system, alcoholism, hyperthyroidism, diabetes, or in the elderly patients.&#x0D; Objective. To evaluate the feasibility of using infusion forms of ATD.&#x0D; Materials and methods. Review of current guidelines.&#x0D; Results and discussion. The advantages of exclusively oral administration of ATD include convenience, low cost, the possibility of usage in an outpatient setting, whereas the main disadvantage is that it is not always possible to create the required concentration of ATD in blood plasma. In turn, the advantages of intravenous ATD include the creation of maximal concentrations in blood plasma and foci of infection, fewer side effects in the digestive system, patients’ awareness of the importance of treatment, whereas disadvantages are high cost and low adherence to treatment. The use of part of the ATD as a step therapy (course of intravenous infusions with subsequent transition to oral administration) allows to create the maximal concentration of active substances in blood plasma and affected organs at the beginning of treatment, to provide better cost/effectiveness ratio in comparison to previously listed regimens, and to increase the treatment adherence without compromising the quality of life of patients. The additional cost of intravenous ATD delivery devices is the main disadvantage. Criteria for the transition from the infusions to oral administration are the elimination of bacterial excretion, obtaining a stable positive dynamics of the clinical condition, elimination of the causes of the need for intravenous treatment (normalization of swallowing function, elimination of malabsorption). Indications for step therapy include the severe forms of TB, severe disorders of the central nervous system and gastrointestinal tract, the presence of severe comorbidities, pre- and postoperative periods, mental disorders, side effects of 3rd-4th degree in case of oral ATD intake. The duration of the infusion course is determined individually, but in average it is about 1-2 months. Such drugs as rifampicin, isoniazid, ethambutol, levofloxacin, moxifloxacin, linezolid, and carbapenems exist in the infusion form.&#x0D; Conclusions. 1. Infusion of ATD as a part of step therapy can improve the quality of treatment of TB patients. 2. Criteria for the transition from infusions to oral administration are the elimination of bacterial excretion, obtaining a stable positive dynamics of the clinical condition, elimination of the causes of the need for intravenous treatment. 3. The duration of the infusion course is determined individually (in average – 1-2 months).

Quantification of pyrazinamide, isoniazid, acetyl-isoniazid, and rifampicin by a high-performance liquid chromatography method in human plasma from patients with tuberculosis.

The aim of this study was to establish and validate an alternative high-performance liquid chromatography method for simultaneous quantification of pyrazinamide, isoniazid, acetyl-isoniazid and rifampicin in plasma of patients under treatment for tuberculosis. The performed method was lineal (r2 >0.99) in the range of 2.00-50.00μg/mL for pyrazinamide, 0.50-20.00μg/mL for both acetyl-isoniazid and isoniazid, and 1.20-25.00μg/mL for rifampicin. Precision and trueness were demonstrated with coefficient of variation<15% and deviations<15%, respectively, for quality controls samples. The lower limits of quantification were 2.00, 0.50, 0.50, and 1.20μg/mL for pyrazinamide, isoniazid, acetyl-isoniazid and rifampicin, respectively. The method was applied for the analysis of plasma from patients with tuberculosis. This method allowed ensuring reliable quantification of the target compounds and their pharmacokinetics parameters. In general, the mean values of maximum concentration of each antituberculosis drug were located within their respective reference therapeutic ranges. However, patients with sub-therapeutic plasma concentrations of isoniazid and rifampicin were detected. This is the first analytical technique that simultaneously quantifies isoniazid, acetyl-isoniazid, rifampicin, and pyrazinamide concentrations from plasma samples by high-performance liquid chromatography with ultraviolet/visible. The proposed method could be applied for therapeutic drug monitoring and pharmacokinetics studies of the four compounds throughout the treatment of tuberculosis patients.

The effect of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active tuberculosis: a retrospective analysis

BackgroundLung tuberculosis (TB) and lung cancer have a complex relationship. Data concerning TB treatment in lung cancer patients are still incomplete. The aim of this study was to investigate the effects of anti-cancer and anti-tuberculosis treatments in lung cancer patients with active lung TB.MethodsIn a retrospective cohort study, lung cancer patients with active lung TB were identified between January 2013 and December 2016. Age- and sex-matched lung cancer patients without tuberculosis were selected as control subjects. Anti-cancer and anti-tuberculosis treatments were administered according to the national guidelines. The clinical courses and responses of lung cancer patients with and without active lung TB were examined and compared.ResultsA total of 31 consecutive lung cancer patients were diagnosed with active lung TB. Fifty-one lung cancer patients without TB were enrolled as control subjects. Most patients in the two groups were elderly, had advanced non-small cell lung cancer and had tumor burdens. The anti-cancer treatment completion rate and response rate were not different between two group (87.1% in TB treatment patients vs. 92.2% in lung cancer patients, 77.4% in TB treatment patients vs. 88.2% in lung cancer patients, respectively). The anti-tuberculosis treatment completion rate and success rate was 87.1 and 80.7%. The median survival times were not different between two groups (52 weeks in TB treatment patients vs. 57 weeks in lung cancer patients). The change in Karnofsky performance score was also not different between two groups. The most common side effect in TB treatment patients was liver injury (61.3%). The most serious side effect in TB treatment patients was leukocyte deficiency (9.7% in Grade 3). Both of side effects mentioned above were not different between two groups.ConclusionBoth anti-cancer and anti-tuberculosis treatments can be safely and effectively administered in lung cancer patients with active lung TB. Attention should be paid to the risk of tuberculosis in lung cancer patients in TB high-burden countries.

Mathematical model for predicting treatment outcome in patients with destructive pulmonary multiresistant tuberculosis

The cessation of bacterial excretion is the main condition for the effective treatment of multiresistant tuberculosis (MRTB). Surgical procedures for treating tuberculosis patients significantly increase the effectiveness of treatment for such patients. The selection of new selection criteria for surgical treatment of MRI is relevant, as it will increase the effectiveness of MRI treatment, which remains insufficient.Objective — to predicting the effectiveness of treatment for MRI of the lungs by developing a mathematical model to predict treatment outcomes.Materials and methods. 84 patients with MRI of the lungs: group 1 (n = 56) — with signs of effective TB treatment at the end of the intensive phase; group 2 (n = 28) — patients with signs of ineffective treatment. We used the multivariate discriminant analysis method using the statistical environment Statistica 13.Results and discussion. During the discriminant analysis, the parameters of the clinical blood analysis (monocytes, stab leukocytes, erythrocytes) were selected, which were associated with high (r &gt; 0.5) statistically significant correlations with the levels of MMP-9, TIMP-1, oxyproline and its fractions and aldosterone in the formation of the prognosis. The mathematical model allows, in the form of comparing the results of solving two linear equations and comparing their results, to predict the outcome of treatment: 1 — effective treatment, 2 — ineffective treatment. Conсlusions. Early prediction of treatment effectiveness is promising, as it allows the use of the developed mathematical model as an additional criterion for the selection of patients for whom surgical treatment is recommended, in order to increase the effectiveness of treatment.

The antibiotic sorangicin A inhibits promoter DNA unwinding in a Mycobacterium tuberculosis rifampicin-resistant RNA polymerase

Rifampicin (Rif) is a first-line therapeutic used to treat the infectious disease tuberculosis (TB), which is caused by the pathogen Mycobacterium tuberculosis (Mtb). The emergence of Rif-resistant (RifR) Mtb presents a need for new antibiotics. Rif targets the enzyme RNA polymerase (RNAP). Sorangicin A (Sor) is an unrelated inhibitor that binds in the Rif-binding pocket of RNAP. Sor inhibits a subset of RifR RNAPs, including the most prevalent clinical RifR RNAP substitution found in Mtb infected patients (S456>L of the β subunit). Here, we present structural and biochemical data demonstrating that Sor inhibits the wild-type Mtb RNAP by a similar mechanism as Rif: by preventing the translocation of very short RNAs. By contrast, Sor inhibits the RifR S456L enzyme at an earlier step, preventing the transition of a partially unwound promoter DNA intermediate to the fully opened DNA and blocking the template-strand DNA from reaching the active site in the RNAP catalytic center. By defining template-strand blocking as a mechanism for inhibition, we provide a mechanistic drug target in RNAP. Our finding that Sor inhibits the wild-type and mutant RNAPs through different mechanisms prompts future considerations for designing antibiotics against resistant targets. Also, we show that Sor has a better pharmacokinetic profile than Rif, making it a suitable starting molecule to design drugs to be used for the treatment of TB patients with comorbidities who require multiple medications.

Incidence of tuberculosis in medical workers of Sumy region for the last decade

Objective — to investigate the trend of tuberculosis incidence of medical workers of Sumy region during the period of reforming medical institutions of anti­tuberculosis type during 2010—2019.Materials and methods. A total of 87 medical workers fell ill with tuberculosis in Sumy region. Among the sick 15 (17.2 %) people are employees of anti­tuberculosis institutions, and 72 (82.8 %) are employees of the general medical network.Results and discussion. A total of 6,149 patients with newly diagnosed tuberculosis have been registered in the region over the years. 1.4 % of them (87 patients) are medical workers. That is, two out of 100 patients with tuberculosis are medical workers. Among all patients with tuberculosis, only 0.2 % (15 people) are employees of anti­tuberculosis institutions, and 1.2 % (72 people) are employees of the general treatment network. The incidence of TB staff was 15.5 per 10,000 employees, and the incidence of general treatment was 3.6. The disease mainly affects women due to the gender composition of health workers. The average number of nurses is more frequent (53.3 % in anti­tuberculosis institutions and 47.2 % in the general treatment network) and paramedics (20.0 and 27.8 %, respectively). With age, the risk of developing tuberculosis decreases, as the most common patients are under the age of 40.Conclusions. The share of employees of the general treatment network is 4.8 times higher than the number of employees of anti­tuberculosis institutions with tuberculosis, which is especially important during the reform of the tuberculosis service, when the main functions of treating tuberculosis patients are transferred to general practitioners — family medicine. General treatment network workers have more common and extrapulmonary forms of tuberculosis, which may indicate a lack of vigilance of general treatment network staff, formal attitude to preventive medical examinations and lack of awareness of infection control in tuberculosis against the background of increasing time with TB patients.