PROBLEMS OF LABORATORY DIAGNOSIS OF TUBERULOSIS IN RUSSIAN PRISONS AT THE PRESENT STAGE
Assessment of the state of laboratory diagnosis of tuberculosis for their compliance with the requirements of clinical guidelines is an important task. Aim: to evaluate in dynamics the quality of microbiological diagnostics of tuberculosis by prisoners in Russia. Materials. We used official statistics for 2015-2021 and specialized inquiries to the medical units of the Federal Penitentiary Service (FSIN) of Russia. Results. In 2020, there was a decrease in the proportion of patients with tuberculosis identified in the units of the Federal Penitentiary Service of Russia providing primary medical care to 3.7%; in 2021, the indicator slightly increased (to 4.4%).The proportion of newly diagnosed patients with a positive sputum microscopy result did not change significantly: 15.9% in 2020 and 16.7% in 2021 (p>0.05).Cultural confirmation of the diagnosis among new pulmonary TB patients after its decline in 2020 to 24.2% increased to 26.7%.The coverage of new pulmonary TB patients by drug sensitivity tests of mycobacterium tuberculosis after its decrease in 2020 to 86.5% increased to 92.0%.The coverage of TB patients (newly diagnosed and with relapses of TB) by rapid TB tests continued to decrease (2020 - 41.4%; 2021 - 37.9%). Conclusion. In 2021, there was a restoration of the volume and quality of most microbiological studies of material from prisoners with tuberculosis.However, the number and list of microbiological studies of material from patients with tuberculosis do not allow the implementation of existing clinical recommendations.The primary problem is the lack of coverage with rapid molecular genetic methods. There is also insufficient coverage of patients with identified resistance to rifampicin by drug-susceptibility testing to fluoroquinolones.Cases of testing patients with tuberculosis for drug sensitivity to bedaquiline and linezolid are episodic.It is necessary to introduce outsourcing of microbiological diagnostic methods on the basis of medical organizations of civil health care, including using interregional and interlevel interaction.It is advisable to test the knowledge of the diagnostic algorithm for identifying the most epidemically dangerous smear positive TB patients by smear microscopy and the possibility of its implementation in units providing primary medical care.