[The specific features of the tuberculosis epidemic situation in the Far North].

The major epidemiological parameters were analyzed in 7 autonomous districts of the Far North of Russia from 1975 to 2002. Throughout the period of observation, tuberculosis morbidity in native dwellers was 5 times higher or more than that in the newcomers and in 2002 it increased up to 292 per 100,000. The incidence of its bacterial forms in the natives was 7-9 or more times greater than that in the newcomers (this index was as high as 126.6 in 2002). The prevalence of tuberculosis accompanied by bacterial isolation in the indigenous dwellers was 7-9 or more times greater than that in the newcomers and ran up to 619.9. In the natives, mortality rates were almost 10 times higher than those in the newcomers. The bulk of the indigenous dwellers live in isolated inaccessible localities. In the indigenous dwellers, the multifold increase in the major indices, as compared to the normal values, was characteristic of the development of the epidemic situation in the Far North. The native dwellers determine the specific features of development of the epidemic situation in the region, thus requiring that special approaches to delivering antituberculous care should be developed.

[Tuberculosis-controlling measures among the populations of increased study complexity and epidemic significance].

The obtained data confirm the epidemic significance and study complexity of populations with the limited fluorographic capacities, homeless persons and residents of inaccessible settlements of the Far North, as well as the necessity of applying special approaches to delivering antituberculous aid in these groups. A system has been developed for the epidemiological surveillance and detection of tuberculosis in the populations of increased study complexity and epidemic significance.

[Organization of antituberculous work with homeless in Saint Petersburg]. / Organizatsiia protivotuberkuleznoi raboty s litsami bez opredelennogo mesta zhitel'stva v Sankt-Peterburge.

The paper deals with organizational measures for detection and treatment of homeless persons with tuberculosis in Saint Petersburg. A total of 1653 homeless tuberculosis patients were followed up in 1991-1997. There was high incidence of tuberculosis in homeless persons (30 detected per 1000 examinees. All agencies, facilities, and services should participate in detecting and treating tuberculosis among homeless subjects. Large-scale solution of this problems requires a package of measures by providing additional funds stipulated by a regional goal-oriented tuberculosis control programme.

[Optimal methods for the detection of tuberculosis in not easily accessible regions of the Extreme North by bacteriological screening]. / Optimizatsiia vyiavleniia tuberkuleza v trudnodostupnykh regionakh Krainego Severa s pomoshch'iu bakteriologicheskogo skrininga.

The results of bacteriological study of 2210 residents of the Extreme North are presented. The author's complex many factorial system of bacteriological screening is discussed, whose use will enable one to raise the detection parameter of bacilli excretors up to 2.93% in the preliminary detected population groups.