Background Growing prevalence of multidrug-resistant/Rifampicin-resistant tuberculosis (MDR/RR-TB; resistance to Isoniazid and Rifampicin/Isolated resistance to Rifampicin) is putting in jeopardy the WHO End TB strategy. This study aimed to identify factors contributing to the high prevalence of MDR/RR-TB in Khabarovsk krai region of Russia. Methods A cross-sectional retrospective study was conducted, analyzing clinical, demographic, and drug susceptibility testing data on 1440 patients. As a source of raw data, the national electronic TB surveillance system was used. Anonymous data was collected on every patient diagnosed with TB in all healthcare facilities of the region from January 2018 to December 2019. Only patients with proven excretion of m. tuberculosis were included in the study. Factors associated with MDR/RR-TB were identified through logistic regression analysis, in conjunction with in-depth interviews with eight patients, five healthcare managers and five doctors. Findings 2661 patients were identified with TB, 1440 were incorporated in the study based on inclusion criteria. Of these, 618 (42.9%) were identified with MDR/RR-TB. Patients with a history of imprisonment were 16.53 times (95% CI 5.37 to 50.88,) more likely to have MDR/RR-TB, whereas re-treatment patients were 2.82 times (95% CI 2.16 to 3.66) more likely to have MDR/RR-TB. Other influencing factors included presence of disability (AOR is 2.32, 95% CI 1.38 to 3.89), cavitary disease (AOR is 1.76, 95% CI 1.37 to 2.25), and retirement status (AOR 0.65, 95% CI 0.43 to 0.98, p = 0.042). Poor patient knowledge and understanding of the disease, progressive weariness of prolonged TB treatment, and inability hospitalize infectious patients without their consent were perceived by the interviewees as major influencing factors. Conclusions Incarceration and treatment history, regardless of outcome, were identified as major factors influencing MDR/RR-TB prevalence. It is essential for the TB care system to eliminate legal loopholes, which deprive doctors of means to enforce quarantine procedures and epidemiological surveillance on infected patients, former and current inmates. Increasing people’s awareness of TB, early detection and appropriate treatment of patients with TB are needed for successfully combating MDR/RR-TB.

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Localization of community-acquired pneumonia (CAP) is its independent clinical sign which has not received proper coverage in the medical literature. The aim of the study is to compare the topical and clinical characteristics of unilateral lobar and segmental CAP in young men. Materials and methods: topical and clinical features of lobar, bi- and monosegmental CAP were studied in 6332 young military men. It was found out that monosegmental CAPs (mCAP) are more variable in their clinical and laboratory manifestations than their bisegamental and lobar variants not identified at the segmental level. The frequency of occurrence of mCAP of a specific localization directly correlates with the frequency of sputum expectoration, the severity of systemic and local neutrophilic inflammation. The 5th and 10th segments of both lungs are the zones of the most frequent localization of mCAP associated with a relatively high severity of systemic neutrophil reaction, and the 6th and 8th segments are the zones of a relatively longer course of mCAP and the predominance of signs of local inflammation. In bisegmental CAP, there is a general trend of a more pronounced systemic inflammatory response to the criterion of blood neutrophils level than in mCAP. The revealed regularities can contribute to a more accurate prediction of the mCAP course in the population of young men.

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