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The implementation of the latest medical reforms requires the synchronization of the system of training and education of medical education with the reform processes in the health care system. Objective — analysis of promising areas of development and improvement of higher medical education in Ukraine and possible ways to implement them in the framework of reforms of practical health care and medical education. Materials and methods. The principles of the strategy «Development of medical education in Ukraine» and the data of available domestic and foreign publications that contain information on possible ways to improve higher medical education were analyzed. Results and discussion. According to the Strategy for the Development of Medical Education in Ukraine, patients are the main value of the medical system, so they should receive high quality services, which can be achieved only with the perfect development of practical skills by future physicians. One of the mechanisms for achieving professional technique of practical skills may be the usage of simulation learning technologies, as it was introduced at the Bukovina State Medical University, along with increasing the number of practical hours for clinical disciplines.To achieve high professionalism and ethics of future physicians, teachers must teach medical students to master the skills of quality search for the most relevant information and ways to improve their professional skills, to form a base of ethical principles of the doctor.With the rapid development of innovative technologies and evidence­based medicine, teachers need to constantly monitor, process and communicate to students only the latest information, in turn, every future doctor should be as interested as possible not only domestic but also global innovations in medicine.Due to the current requirements for the medical labor market, it is reasonable to select only highly motivated students for higher education, who will meet the latest requirements for certification of students and form a strong market for competitive medical knowledge and skills.Conclusions. The process of reforming the medical sector in Ukraine requires a change in many approaches to the organization of the educational process and the quality of medical education. This is a complex process, the implementation of which is possible only with the joint participation of state mechanisms for financing, organizing and controlling the educational process, as well as the direct participation and hard work of educational institutions that train medical professionals.

Background. A statistical analysis published in the WHO report for 2019 showed that almost 10.0 million people (about 9.0-11.1 million) fell ill with tuberculosis (TB) worldwide in 2018. The purpose of a systematic examination and analysis of the WHO report is to summarize the achievements and study of complex issues in overcoming tuberculosis in the world at the present stage, that need more attention, more scrutiny, or a change in approach to addressing specific challenges towards achieving the strategic global goals for eradicating this infection. Materials and methods. We used test access to such full – text and abstract databases: a single package of the information database EBSCO; the largest abstract and citation database of peer-reviewed literature Scopus; Google Scholar; MEDLINE with Full Text; MEDLINE Complete; Dyna Med Plus; EBSCO eBooks Clinical Collection; Web of Science Core Collection WoS (CC); SCIE (Science Citation Index Expanded); SSCI (Social Science Citation Index); AHCI (Artand Humanities Citation Index). Results and discussion. By geography, most TB cases in 2018 were reported in the WHO regions: Southeast Asia – 44 %, African – 24 % and Western Pacific – 18 %. Lower percentages were recorded in the Eastern Mediterranean (8 %), America (3 %) and Europe (3 %). Eight countries account for two – thirds of the world’s total TB cases: India (27 %), China (9 %), Indonesia (8 %), Philippines (6 %), Pakistan (6 %), Nigeria (4 %), Bangladesh (4 %) and South Africa (3 %). These and 22 other countries on the WHO list of 30 high tuberculosis countries account for 87 % of TB worldwide. Multidrugresistant tuberculosis (MDRTB) continues to be a public health threat worldwide. In 2018, about half a million new cases of rifampicin-resistant tuberculosis were reported (of which 78 % had multidrug-resistant tuberculosis). The three countries with the largest share of the global MRTB burden are India (27 %), China (14%) and the Russian Federation (9 %). Globally, 3.4 % of new cases of tuberculosis and 18% of previously treated cases are tuberculosis with extensively resistance or rifampicin-resistant (MDR/RR-TB), with the highest rates of detection (>50 % in previously detected cases) in the countries of the former Soviet Union. Conclusion. The epidemic situation in TB in the world and Ukraine remains complex and at this stage has certain peculiarities, and the prognosis for its overcoming shortly is rather doubtful. There is a tendency to reduce the incidence of tuberculosis, but several complex and controversial issues have been outlined for the eradication of this infectious disease by WHO’s End TB strategy.

Aims: To carry out a comprehensive retrospective assessment of the prevalence, features and course of treatment of patients with multidrug-resistant tuberculosis (MDR-TB) and diabetes mellitus (DM). Materials and Methods: Our study is based on a retrospective analysis of statistical data obtained from 762 current and former MDR-TB patients (74% of patients with resistance only to first-line drugs – isoniazid (H) and rifampin (R); 36% with resistance to H, R and second-line drugs) included in the register of tuberculosis (TB) patients from different regions of Ukraine and the Grodno region of the Republic of Belarus between 2015 and 2019. Results and Discussion: In both groups of the study recurrent TB prevailed: 49 cases (55.7%) of relapse TB compared to 39 cases (44.3%) of primary TB in the main group; 363 cases (53.9%) of relapse TB compared to 311 (46.1%) primary TB in the control group (P < 0.05). The rate of successful treatment in the control group is higher than in the main group (64.7% vs. 61.4%; P < 0.05). A significant difference between the two groups was observed owing to the difference in frequency of treatment, which in the main group has recorded 27.3%, as against 40.3% in the control group (almost two times lower; P < 0.05). Conclusions: The association between TB and DM increases the morbidity, chemoresistance and proportion of recurrences. Pulmonary TB developed significantly more often in middle-aged patients with type 2 DM with moderate and severe states, with subcompensated form and with a complicated course.

Les changements morphologiques de la membrane muqueuse de l'intestin grêle dans la co-infection VIH/Mycobacterium tuberculosisIntroduction. A ce moment, il n'y a pratiquement pas de données sur les modifications pathomorphologiques de la muqueuse de l'intestin grêle lors de la co-infection VIH/tuberculose, ce qui pourrait être à la base du développement d'une malabsorption. Le but de l'étude est d'étudier les caractéristiques de la structure morphologique de l'intestin grêle dans la tuberculose associée au VIH. Matériaux et méthodes. L'étude prospective pathomorphologique a inclus 24 patients avec co-infection VIH/Mycobacterium tuberculosis (groupe principal) et 20 personnes sans infection par le VIH, de pathologie gastro-intestinale ou de signes morphologiques de tuberculose (groupe témoin). Résultats. L'épaisseur de la petite muqueuse intestinale, la hauteur et la largeur moyennes des villosités