Neglected tropical diseases (NTDs) have long been overlooked in the global health agenda. The article is intended to generate information in consideration of the history of colonization of tropical countries with a special focus on tropical diseases especially common in the army during colonial wars and throughout the colonial era. Extreme poverty and warm tropical climates are the two most potent forces promoting the spread of neglected tropical diseases. European colonial doctors made valuable contribution towards understanding them and discovery these diseases. Large outbreaks of infectious and tropical diseases occurred in the Army throughout the colonial era, strongly influenced the formation of the Army Medical Services including provision for teaching and research. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from tropical diseases. Now in an era of “globalized” environment of interdependent trade, travel, migration, and international economic markets, many factors play an important role in the rise, emergence, and reemergence of tropical infectious disease, which necessitates a coordinated, global response. Many of the emerging and reemerging infectious diseases are also “neglected,” meaning they impact the world’s poorest and lack adequate funding and innovation for prevention and treatment, with some not adequately identified or studied. Although progress has been made in the management of neglected disease, there remains much work to be done. During the coming decade the global response will be able to further build on today’s successes, align with the new global health and development frameworks.

The review article discusses vaccines against SARS-CoV 2 based on adenovirus vectors currently used in the world. The concept of creating vector vaccines is described. The data of clinical studies on the efficacy and safety of registered adenovirus-vector vaccines for the prevention of new coronavirus infection are presented. The frequency of serious adverse events after their use is described in detail. In addition, the clinical efficacy of vector vaccines for changing genotypes of the Covid 19 virus has been determined.

The review analyzes literature data on the safety and efficacy of vector vaccines against coronavirus infection.

The vector vaccines currently used against the new coronavirus infection are quite safe and effective even in relation to the new genotypes of the SARS-CoV 2 virus.

This review article discusses the pathophysiological mechanisms of the development of coronavirus infection in obese patients. It has been shown that obesity is considered as the most important risk factor for the development of many comorbid diseases, including severe forms and deaths as a result of a new coronavirus infection. The higher incidence and severity of a new coronavirus infection in obese patients is based on a complex of factors, the main of which are an increase in cardiovascular risk, including a tendency to thrombosis, a decrease in the efficiency of the respiratory system, impaired immune response, and the presence of chronic inflammatory state. The article discusses non-drug approaches and issues of pharmacological therapy in patients with obesity in the context of a pandemic of a new coronavirus infection. It is shown that the implementation of national quarantine measures has led to an increase in physical inactivity, the level of stress and a change in the eating behavior of the population, closing a vicious circle and contributing to an increase in body weight. For this reason, the efforts of physicians of therapeutic specialties should be directed primarily to increasing resistance to infection among obese patients and combating physical inactivity. The main groups of drugs that can be used to combat lipotoxicity are listed. It was noted that infectious disease doctors and endocrinologists can use those groups of drugs that affect the most vulnerable pathogenetic triggers for the development of obesity and comorbidities: hunger and satiety processes, decreased insulin sensitivity, development of lipotoxicity and chronic inflammation. It has been proven that the range of positive effects of new antihyperglycemic drugs from the groups of type 1 glucagon-like peptide agonists and type 2 sodium-glucose transporter inhibitors, combined with a well-studied efficacy and safety profile, represents a new opportunity for the treatment of obesity in the context of a coronavirus infection pandemic.

The article presents an overview of current trends in the epidemiology of respiratory syncytial viral (RSV) infection, including its seasonality, under the impact of the COVID-19 pandemic, both according to world literature and taking into account monitoring epidemiological studies conducted in the Russian Federation. A detailed description of the dynamics of RSV detection in the period 2020-2021 and the beginning of 2022 in Russia according to the results of the all-Russian epidemiological monitoring is given. Epidemiological studies in different regions of the world, including Russia, have revealed the absence of seasonal rises in the incidence of RSV infection, characteristic of previous years, in 2020 and winter-spring in 2021 under the influence of the COVID-19 pandemic. In 2021-2022, a sharp increase in the incidence and hospitalization of children was noted against the back-drop of a decrease in cases of a new coronavirus infection in all countries of the world, while the start time and duration of respiratory syncytial virus infection, typical for the prepandemic period, changed. Our previous studies have shown that in different years and in different regions of Russia, the start and end times of the epidemiological season may also not coincide, which makes it difficult to predict seasonal peaks in incidence, their duration and severity only on the basis of previously obtained data. This makes it expedient to extend the terms of passive specific prophylaxis with palivizumab for a year if there are indications for its use, including taking into account the data of epidemiological monitoring conducted in the Russian Federation.

Current insights into the close relationship between human health and the gut microbiota, as well as recent advances in molecular biology suggesting a significant role for gut viromas, have encouraged research into the therapeutic usefulness of bacteriophages.

The purpose of this review is to consider the prospects for the use of bacteriophages for the correction of the gut microbiota and therapy of digestive system diseases.

The review describes the basics of phage biology, peculiarities of bacteriophage virome of the intestine in gastroenterological pathology; it highlights modern methods of phage-based therapy and prevention, considers problems of phage therapy and ways to overcome them. It is shown that the use of phages can become a key personalized approach to the treatment and prevention of infectious and non-infectious gastroenterological diseases.

The literature review is devoted to the modern concept of human betaherpesvirus 6 (human herpesvirus 6; HHV-6). The analysis of the literature mainly for the last five years was carried out. The article provides a brief background on the history of the discovery of viruses, highlights the taxonomy of HHV-6, new views on the etiological features of the HHV-6A and HHV-6B viruses, in particular, the possibility of their gene integration. Differences between HHV-6A and B are described. Modern views on the etiological relationship of various diseases of the central and peripheral nervous system, а heart, other organs and systems with HHV-6A and HHV-6B are presented. There have been cases of infectious mononucleosis associated with HHV-6, as well as exanthemа subitum that is mostly typical for children under 2 years old. Modern ideas about the possibilities and problems of HHV-6 infection laboratory diagnosis and treatment of children and adult are given. Obtained data points out necessary of a unified protocol creation for the examination and treatment of HHV-6.

Since the onset of the SARS-CoV-2 infection, there has been an increase in the number of reports of patients who have experienced the development of autoimmune neurological disorders. It is assumed that such an increase in the incidence rate may occur due to an abnormal immune-mediated response of the body to the pathogenic impact of SARS-CoV-2. This article discusses the possibility of the influence of SARS-CoV-2 on the onset and exacerbation of the course of autoimmune neurological disorders, possible pathogenetic factors and mechanisms, and analyzes the features of the clinical picture and therapy. The article includes foreign and Russian scientific data and clinical observations of cases of Guillain-Barré syndrome, multiple sclerosis, acute disseminated encephalomyelitis, myasthenia gravis and other autoimmune diseases that have changed their typical course on the background of COVID-19.

Infective endocarditis (IE) is one of the most common cardiac complications in HIV patients who are intravenous drug addicts. The presence of IE and secondary diseases in immunocompromised individuals usually requires specific diagnostic and therapeutic approach.

Aim: Optimizing the diagnosis of IE in patients with advanced HIV/AIDS.

Materials and methods We reviewed 429 case records of HIV/AIDS ICU patients using the modified duke criteria for diagnosis of infective endocarditis. Statistical significance (p <0.05) of data was assessed using the χ² test.

Results. 25 patients were diagnosed with IE. The male gender dominated – 68%. Mean age was 38. 60% had stage 4B HIV infection. 68% were ART naive. The medium viral load was 294560 copies / ml, while the medium CD4 count was 218 cells / μl. Fever of >38°C was a key symptom found in all patients. Blood cultures were positive in 60% cases. 80% had a high C reactive protein (CRP), and 44% had CRP levels above 100 mg/l. Procalcitonin (PCT) levels were increased in 52%. Echocardiogram revealed IE in 92%. Pneumonia was diagnosed in 92%. Fatal outcome occurred in 76%. Anemia was a predictor of severe outcome (p<0.002), while patients with leukocytosis had good prognosis (p<0.05).

Conclusion. Infective endocarditis is a common complication among HIV IDUs. The most common diagnostic criteria are fever >38°C, pneumonia, anemia, leukocytosis, thrombocytopenia and echocardiographic findings. The levels of the hemoglobin and WBCs could evaluate prognosis of the disease outcome.

Objective: to analyze clinical manifestations, diagnostic and therapeutic approaches to management of pregnant women with cytomegalovirus infection for optimization of clinical and laboratory diagnostics and reduction of risks of congenital cytomegalovirus infection in the postnatal period.

Materials and methods: in the article describe results a retrospective study the pregnancy course of 92 women who had 94 children with a confirmed congenital manifest form of cytomegalovirus infection. The inclusion criteria in main group were women aged 18-40 years and presence the results of examination for TORCH-syndrome in the first trimester of pregnancy, negative results for HIV. Markers of cytomegalovirus infection were determined by PCR (blood, vaginal secretions) and serologically (IgM, IgG to CMV-infection).

Findings: the study showed that acute cytomegalovirus infection was documented during pregnancy in 18.4% of cases, and recrudescence of CMV-infection only in 33.6% of cases. Acute cytomegalovirus infection was asymptomatic in 35.3% of patients, the rest had nonspecific symptoms in the form of fatigue and headache, cholestasis was registered in 35.2% of cases, whereas with recrudescence of cytomegalovirus infection, catarrhal symptoms in the form of rhinitis and pharyngitis prevailed 42,8% cases, p<0,05. 15 people received therapy during pregnancy: 2 of them – antiviral (valgancyclovir), 11 – immunocorrective (interferon2alfa) and 2 – pathogenetic therapy (blood transfusion to the fetus for anemia). Based on the literature data and obtained by analyzing management tactics of the observed pregnant women, an algorithm for the management of pregnant women with cytomegalovirus infection was created.

Conclusion: the study made it possible to substantiate algorithm of diagnosis and tactics management of cytomegalovirus infection in immunocompetent pregnant women and gave recommendations for obstetricians and gynecologists about alertness regarding cytomegalovirus infection.

The aim of the study was to analyze the mortality of patients infected with the hepatitis C virus (HCV) and co-infected with the human immunodeficiency virus (HIV) with extrahepatic manifestations associated with cryoglobulinemia, and to assess the dependence of the risk of fatal outcome on such predictors as the presence of HIV infection, the presence of cirrhotic liver transformation, antiviral therapy (AVT) of chronic hepatitis C, cryoglobulin levels.

Materials and Methods. The prospective study included 125 patients with HCV (n=92) and HCV/HIV infection (n=33) who had extrahepatic manifestations (arthralgia and/or skin hemorrhagic rashes and/or polyneuropathy and/or or Raynaud’s syndrome and/or xerophthalmia and/ or chronic kidney disease), as well as cryoglobulins.

Results. 19 out of 125 patients (15% (95% CI 10-23%)) died in the follow-up period from 1 to 170 months (median 57 months), among which 12 people did not receive AVT for HCV infection during the follow-up period and 7 patients underwent AVT during the observation period. Unadjusted mortality among patients treated with AVT was 9% (95% CI 5–18%) (n=7/77), those who did not receive it was 25% (95% CI 15–39%) (n=12/48), χ²=5,806, p=0,016. Cox regression analysis showed that an increase in the risk of death is associated with the presence of cirrhotic liver transformation by 5,3 times and the absence of AVT by 3,7 times. The main causes of death in 69% of cases were causes not associated with liver pathology, in 26% were complications of liver cirrhosis (bleeding or progressive encephalopathy), in one case (5%) the cause of death remained unknown.

Conclusions. Мortality among patients with HCV or HCV/HIV infection complicated by the development of extrahepatic manifestations associated with cryoglobulinemia is higher in the absence of AVT than in the case of AVT. Cirrhotic liver transformation and the absence of AVT significantly affect the risk of death. Patients with extrahepatic manifestations die mainly from causes not associated with liver pathology.

At present, there are isolated data on the clinical outcomes of COVID-19 in children, especially those who have experienced asymptomatic and mild forms of infection.

Purpose: to analyze the nature and frequency of postCOVID symptoms in children during 12 months. after recovery.

Materials and methods. The influence of demographic indicators, premorbid background, severity of infection and therapy in the acute period of the disease on the nature and frequency of symptoms in 1079 children who underwent laboratory-confirmed COVID-19 was studied. The results are presented with proportions (%) and calculation of 95% confidence interval according to Klopper-Pearson. Differences between groups were assessed using Pearson’s chi-square test. Differences in the groups were considered statistically significant at p < 0,05.

Results. Health disorders in the post-COVID period were observed in 8,5% of children, more often in school-children aged 7–17 years (68.4%). Concomitant conditions were found in 38,0%. In most cases, the consequences were noted after a mild form of COVID-19 (77.2%), however, 13,0% of patients experienced an asymptomatic form of infection. Among convalescents, changes in the emotional sphere (2,1%), headache (1,8%), symptoms of asthenia (1,6%), cardiovascular (1,5%), dyspeptic (1,3%) were more often observed, cognitive (1,3%) disorders, neurotic disorders (1,0%), less often respiratory (0.8%), endocrine (0,4%) and visual (0,4%) systems, musculoskeletal system were involved (0.2%). Girls were significantly more likely to have vegetative disorders, while boys were significantly more likely to suffer from cognitive functions. Various antiviral therapy options (interferon-alpha, an oral antiviral drug, or a combination thereof) in the acute period of COVID-19 did not affect the possibility of post-COVID disorders, but there was a tendency to increase the frequency in children who did not receive etiotropic treatment (control group). In 14.1% of cases, post-COVID symptoms appeared late – after 5–10 months. after recovery. The course of rehabilitation therapy, including drug treatment and non-drug methods, made it possible to quickly restore the state of health of the observed children.

Conclusion. In most cases, the violations were of a functional nature, due to a disorder of autonomic regulation. Rehabilitation and dispensary observation programs will allow timely restoration of the quality of life of children who have had COVID-19, including in a mild and asymptomatic form.

The aim. To investigate the clinical peculiarities of adult patients with diarrheal syndrome, associated with coronavirus infection COVID-19.

The materials and methods. There has been carried out the analysis of 56 patients aged 26-81 years, hospitalized with acute enteric infection at the Municipal Infectious Diseases Hospital №8 (not reprofiled as hospital for the treatment of coronavirus infection COVID-19 patients) in the course of August 2020 – February 2021 and the patients with cause-effect relationship with COVID-19. There have been used the routine diagnostic methods, the analysis of feces for causative agents of diarrhea was tested by the methods of bacteriological and immunoenzymatic analysis, the analysis of feces for toxins A and B Clostridium difficile was tested method of immunochromatographic assay; the blood serum was tested by method of immunoenzymatic analysis and the analysis of nasopharyngeal swabs was tested by immunochromatographic assay and PCR test for markers SARS-COV-2. The statistical material treatment has been done using Statistical Package of IBM SPSS Statistics-22.

The results. There have been registered 51,8% of cases – diarrhea as one of the clinical manifestations of COVID-19 in adult patients (the first group of patients), in 48,2% of cases – diarrhea as a result of recently treated COVID-19 and a massive course of antibiotics (the second group of patients). In the second group 12 patients have been diagnosed with clostridial infection, 15 patients – with antibiotic-associated diarrhea. There has been registered the main severity of clinical manifestations in patients with clostridial infection. The disease being characterized by severity of colitis syndrome, the blood sedimentation rate increasing, hyperleukocytosis in haemogram, hypoproteinemia and hypoalbuminemia. The aggravating factors are combined comorbidity and patients aged over 55 years.

The conclusion. There should be used the differential approach for diarrheal syndrome in patients with coronavirus infection. Taking into account the massive course antibiotics’ side effects, the analysis of feces for pathogenic flora must be included into the medical examinations such as Clostridium difficile and the course of probiotic and anticlostridial medicines should be done.

We present the results of a prospective multicenter study of risk factors, etiology, clinical features, and treatment outcomes for mucormycosis in patients with COVID-19 (COVID-M) in the Russian Federation.

The study included 60 adult patients with COVID-M. To analyze risk factors for COVID-M, we conducted a case-control study. The control group included 60 adult patients with COVID-19 without mucormycosis. To analyze the clinical manifestations of COVID-M, we created a control group of hematological patients with mucormycosis examined in 2011–2020.

In patients with COVID-19, the risk of developing mucormycosis was significantly increased with diabetes mellitus (OR=49) and overweight (OR=4,75), as well as with the use of high (≥100 mg per day for prednisolone) doses of glucocorticosteroids (OR= 4,762), especially ≥10 days (OR=25,4). The main localization of mucormycosis in patients with COVID-19 was the paranasal sinuses (95%) and the orbit (68%). Involvement of ≥2 organs was identified in 70% of patients. The main causative agents of mucormycosis were Rhizopus arrhizus (43%) and unidentified mucormycetes (36%).

90-days overall survival of patients with mucormycosis and COVID-19 – 71%. The stay in the ICU (p=0,01), the use of mechanical ventilation (p=0,0481), the presence of CVC (p=0,049), CNS damage (p=0,016) and ≥ 2 organs (p=0,048) significantly worsened the prognosis of the disease. The best prognosis was in patients who received antifungal therapy (p=0,03875) and surgical treatment (p=0,046).

Aim. To determine the threshold value of the Epstein-Barr virus (EBV) viral load (VL) in blood leukocytes to improve the laboratory diagnostics of infectious mononucleosis in children.

Materials and methods. EBV DNA quantification in blood leukocytes in children aged 1-17 years (n=163) was determined by real-time polymerase chain reaction. VL were compared in groups of EBV mononucleosis (n=67), non-EBV mononucleosis (n=25) and healthy donors (n=25). Threshold was determined based on VL data from children with active and latent EBV infection. The R program and the RStudio environment were used for satistic analysis.

Results. EBV DNA is found in blood leukocytes in infectious mononucleosis not associated with EBV and in healthy virus carriers, however VL in these groups is significantly lower than in patients with EBV mononucleosis (p<0.001). The threshold value was determined – 41 copies/10⁵ cells (or 1.6 lg of EBV DNA/10⁵ cells), which was characterized by acceptable values of specificity and sensitivity (0.90 and 0.85, respectively) of laboratory diagnostics. High EBV VL (equal to or above the set threshold) is associated with an 8.5-fold increased risk of detecting active EBV infection compared to children who have a low VL (below a set threshold) (RR 8.5; 95% CI: 3.7–19.7, p<0.001).

Conclusion. In general, the results obtained create prerequisites for more intensive implementation of quantitative studies of EBV DNA in blood leukocytes, both in the context of improving the early diagnosis of infectious mononucleosis and its etiological interpretation, and in terms of detailing the features of the course of EBV infection.

The aim of this study was to identify the features of CD4+ lymphocytes apoptosis in children with cryptosporidiosis. Feces for the detection of cryptosporidium and venous blood for the study of lymphocytes apoptosis were the material of the study. Mononuclear leukocytes were isolated from venous whole blood and cultured in a complete culture medium. Cells were incubated for 24 hours with inducers of the receptor (TNFα) and mitochondrial pathways of apoptosis (dexamethasone).

Cryptosporidia have been found in 35% of acute intestinal infections in children. The number of lymphocytes with cytoflurimetric signs of apoptosis in the group of cryptosporidiosis-positive patients did not differ from that in patients without cryptosporidiosis (p=0.421). There were no intergroup differences in the number of CD4+ lymphocytes expressing the Fas receptor on their surface (p=0.462). In cultures incubated in the presence of dexamethasone, a decrease in the number of apoptotically altered CD4+ lymphocytes was registered only in the group of cryptosporidiosispositive patients (p=0.028).

The study showed that in cryptosporidiosis, the sensitivity of CD4+ cells to the induction of the mitochondrial pathway of apoptosis changes in favor of slowing down this variant of cell death.

Objective: In this research, the clinical and laboratory characteristics of Crimean-Congo hemorrhagic fever (CCHF) in Uzbekistan were studied. The study is considered useful for prevention and case detection, especially in condition of limited sources.

Materials and Methods: This study was aimed to determine the clinical and laboratory characteristics of 81 confirmed cases of CCHF among patients who were admitted to infectious diseases hospitals in Uzbekistan from June 2011 to June 2018. The results of this study are based on a retrospective analysis of all confirmed patients.

Results: 81 patients with CCHF confirmed by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) methods were examined. The research participants were mainly rural residents – 73 people (90%), 7 people from cities (8.5%), 1 person (1.5%) – a resident of the capital – Tashkent. The age of the patients ranged from 14 to 66 years, with an average of 35.9 ± 12.4 years. 39.5% (32 people) of the participants were women, the remaining 60.5% (49 people) were men. Mortality was 23% (19 patients) with an insignificant difference between men and women (p = 0.8). Most cases were reported from June to September.

Conclusion: The occurrence of CCHF among rural residents once again confirms the geographical features and focal nature of the infection. The high contagiousness of the disease is demonstrated by the infection of medical workers, due to the close contact of staff with patients.

We did not note the significant relationship between mortality and the period from the onset of the disease to hospitalization. However, there was a strong correlation of mortality with the days of hospital stay, with the blood clotting time and with the level of consciousness of patients.

In order to clarify the frequency and duration of changes in the functional state of the cardiovascular system in typhoid patients, as well as the definition of the structure and features of injuries in modern conditions, the medical records of 286 patients were analysed retrospectively, including 36 persons with a fatal outcome among members of a limited contingent of Soviet troops in Afghanistan (1983–1985). The results of the tests in the deceased were compared to the autopsy of the tissues of their bodies.

The nature of the changes in the indicators of the functional state of the cardiovascular system during various periods of light, medium, heavy and extremely severe forms of typhoid fever and their diagnostic informativeness, structure, as well as the frequency of registration are explained, features of clinical and morphological manifestations of infectious toxicity shock, thrombohemorrhagic syndrome, myocardial dystrophy, infectious toxicity myocarditis, as well as the significance of pre-mortem status in this disease. It has been established that patients with an extremely severe form of relapse of typhoid in connective tissue develop in the intercardiomyocytic intervals.

The article presents a clinical observation of severe acute hepatitis of unknown aetiology with liver transplantation in a 16-year-old child, which occurred in October 2021. Initial symptoms were abdominal pain, diarrhea. The general wellbeing of the girl did not suffer, there was no fever, no intoxication syndrome. Over the next days, she began to notice the appearance of edema on the legs, an increase in the size of the abdomen. From the 10-11th day of illness – darkening of urine, acholia of feces, jaundice were observed. She was examined by a pediatrician, a biochemical blood test was performed, according to the results the girl was hospitalized with a diagnosis of acute hepatitis. According to the severity of the condition, she was hospitalized in the ICU. On admission she complained of abdominal pain, jaundice, edema, and weakness. On examination: jaundice, scleral icterus, hemorrhagic rash at the site of the tourniquet, bleeding from injection sites, hepatomegaly, anasarca. In blood tests: progressive anemia, thrombocytopenia, increased AST (with a decrease in dynamics against the background of progression of liver failure), a decrease in total protein and albumin, fibrinogen, prothrombin according to Quick. Laboratory excluded viral hepatitis A-E. The only infectious agent diagnosed was group F adenovirus in feces. By the third day of hospitalization developed of multiple organ failure, DIC. On the 4th day of hospitalization, the child was transferred to a specialized hospital, where an emergency liver transplantation was performed. The operation was successful, the child was discharged in a stable condition.