[Equipping the bacteriological laboratories of a tuberculosis service as the most important element of assurance of the quality and safety of their work].

By taking into account the present requirements for the equipping of the laboratories, the authors have drawn up the minimum standard list of equipment, as well as a list of additional equipment for the specialized bacteriological laboratory of a tuberculosis-controlling institution, which performs microbiological studies for the diagnosis and control of chemotherapy for tuberculosis. The specifications and characteristics of the baric types of equipment used to fit out the laboratories under the present conditions are described. Equipping the laboratories in accordance with the draw-up lists is shown to ensure a qualitative, effective, and safe work.

[Development of criteria for assessing the quality of microbiological studies and for evaluating their efficiency in tuberculosis service facilities and the general health network].

The major available indicators of the efficiency of laboratory service activities in diagnosing tuberculosis, including those widely used in international practice and Russian traditional tuberculosis statistical data, are analyzed. The optimal criteria for assessing the quality and efficiency of work of the clinical diagnostic laboratories of the general health network and the bacteriological laboratories of a tuberculosis service in the detection, diagnosis, and chemotherapy monitoring of tuberculosis have been developed. The recommended levels of the indicators, which are to be achieved by well working laboratories, if a well-implemented tuberculosis-controlling program is available, are defined.

[Monitoring of drug resistance in Mycobacterium tuberculosis in The Republic of Mariy El].

Drug resistance (DR) in Mycobacterium tuberculosis (MBT) has been monitored in the Republic of Mariy El. It has been established that there is a considerable prevalence of drug-resistance strains even among new cases. There is a gradual rise in the level of MBT DR, including multiple DR (MDR).

[The state-of-the-art of Russia's Laboratory Tuberculosis Diagnosis Service: basic problems and ways of their overcoming].

The authors have revealed the acutest problems of laboratory tuberculosis diagnosis service in the Russian Federation. They have made their conclusion on this issue and developed the following recommendations: to continue the reorganization of Russia's laboratory tuberculosis diagnosis service; to reconstruct and repair laboratories; to provide them with up-to-date equipment; to make a full-scale training of laboratory workers; to standardize the procedures of microbiological tests for tuberculosis; to organize bacteriological tuberculosis service monitoring in Russia, including monitoring of tuberculosis-controlling facilities; to develop and officially approve a number of normative documents (current standards for the time spent on working operations and criteria for estimating the load on the personnel performing the procedures of a study, new staff lists for laboratories, the level and structure of salaries in the laboratory's personnel).

[Ways of enhancing the effectiveness of bacterioscopic diagnosis of tuberculosis in general health care facilities in case of pilot areas of Russia].

The experience of researchers of the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, in the pilot areas of Russia has made it possible to perfect approaches to improving a bacteriological diagnosis of tuberculosis in general health care facilities. A decisive role in enhancing the effectiveness of detection of patients with tuberculosis by the Ziel-Nielsen test is played by the following factors: training of laboratory personnel; provision of laboratories with high-grade equipment and reagents; introduction of the methods and techniques unified and approved by the Ministry of Health of the Russian Federation; regular supervision of jurisdictional laboratories; outside control of the quality of studies. Proper organization of examination of patients, including an effectual selection of patients to be examined, the observance of the established frequency of their examination, and provision of the required quality of a taken sample greatly affect the efficiency of a microscopic diagnosis of bacillary patients.