Treatment outcomes and risk factors for an unsuccessful outcome among patients with highly drug-resistant tuberculosis in Ukraine.

OBJECTIVES: To describe demographics, clinical features, and treatment outcomes of patients with highly drug-resistant tuberculosis (TB) in Ukraine, and to evaluate risk factors for an unsuccessful outcome. METHODS: Data from patients with multi-, pre-extensively, or extensively drug-resistant TB were collected prospectively from TB dispensaries in 15 out of 24 Ukrainian oblasts (regions) from 2020 to 2021. Treatment outcomes were evaluated using WHO definitions. Risk factors for an unsuccessful outcome were identified using a multivariable logistic regression model. RESULTS: Among 1748 patients, the overall proportion of successful outcomes was 58% (95% confidence interval [95% CI] 56-60) (n = 1015/1748), ranging from 65% (95% CI: 62-69) (n = 531/814) for multidrug-resistant TB to 54% (95% CI: 49-58) (n = 301/563) for pre-extensively drug-resistant TB and 49% (95% CI: 44-55) (n = 183/371) for extensively drug-resistant TB. Results were similar across oblasts, with few exceptions. The strongest risk factors for an unsuccessful outcome were extensively drug-resistant TB (adjusted OR [aOR] 3.23; 95% CI: 1.88-5.53), total serum protein below 62 g/L in adults and below 57 g/L for children and adolescents (aOR 2.79; 95% CI: 1.93-4.04), psychiatric illness (aOR 2.79; 95% CI: 1.46-5.33), age at TB diagnosis >65 years (aOR 2.50; 95% CI: 1.42-4.42), and alcohol misuse (aOR 2.48; 95% CI: 1.89-3.26). DISCUSSION: The overall proportion of successful outcomes among Ukrainians treated for highly drug-resistant TB was 58%, notably better compared with previous years, but still low for extensively drug-resistant TB. Risk factors for unsuccessful outcomes highlight that addressing socioeconomic factors in TB management is crucial. Efforts in maintaining TB dispensaries during and following the ongoing war are highly warranted.

PREVALENCE OF SENSORY DYSFUNCTIONS IN ADULT UKRAINIAN POPULATION WITH LABORATORY CONFIRMED COVID-19.

OBJECTIVE: The aim: To analyse the structure of sensory impairments, associated with COVID-19. To identify terms of recovery periods depending on severity of disease, age and gender of the patients. PATIENTS AND METHODS: Materials and methods: Within two weeks, 2225 patients with confirmed COVID-19 completed a questionnaire, created by Google Forms. General complaints, peculiarities of sensory impairments and recovery time were specified. After exclusion criteria application, data of 2108 patients were analyzed by R Statistics Package, Student's t-test, Wilcoxon rank-sum test, Fisher's exact test, Spearman's rank test. RESULTS: Results: Among patients enrolled (973 males and 1135 females, mean age 28.6±0.18) the most frequent were olfactory (91.32%) and gustatory (66.03%) dysfunctions. Olfactory manifestations were usually accompanied by gustatory disorders (73.72%). Average duration of olfactory dysfunction was 15.46±0.45 days, gustatory - 11.3±0.33, hearing - 4.3±0.16, and visual - 6.53±0.23 days. It was found a correlation between duration of olfactory and gustatory impairments (r=0.65; p < 0.001), hearing and visual disorders (r=0.49; p < 0.05). CONCLUSION: Conclusions: Olfactory and gustatory disorders are prevalent symptoms in Ukrainian population. 7.87% of respondents who had impairment of all four sensory functions had the longest recovery time. Duration of sensory impairments did not depend on age, type of treatment and severity of disease, which rises the question about the neurogenic pathway of virus.

THE QUALITY OF LIFE FOR STUDENTS IN EDUCATIONAL INSTITUTIONS: CURRENT SITUATIONS AND BASIC PRINCIPLES OF PSYCHOHYGIENIC IMPROVEMENT.

OBJECTIVE: The aim: To develop the key principles of psychohygienic improvement of the processes of personality formation and enhancement of the quality of life of pupils and students of modern educational institutions of various types. PATIENTS AND METHODS: Materials and methods: While working out the basic principles of psychohygienic correction of the processes of personality development and improvement of the quality of life of pupils and students of modern educational institutions of various types, we have conducted surveys of the adolescent boys and girls studying at five modern educational institutions in Ivano-Frankivsk city, namely Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk Finance Commercial Cooperative College named after Stepan Hranat, Ivano-Frankivsk State Music School named after Denys Sichynskyi, Ivano-Frankivsk Vocational Lyceum of Road Transport and Construction No. 15, and Ivano-Frankivsk Boarding Lyceum for Gifted Young People from Rural Areas. A total of 420 pupils and students studying at different types of educational institutions took part in the survey. They were in both natural and preformed conditions due to application of the program of psychophysiological effects on the body, psychohygienic correction of personality development processes and improvement of the quality of life of pupils and students. RESULTS: Results: While conducting the research, we have noted that the practical application of the program of psychophysiological effects on the body, psychohygienic correction of personality development processes and improvement of the quality of life of pupils and students occurs at mental, personal and psychophysiological levels of the adolescent boys and girls, anticipating correction of emotional, motivational and behaviour-based key characteristics of personality, psychophysiological adaptation and quality of life, thus being a platform for development of creative potential, self-analysis, self-expression and self-control skills, as well as discovery of positive landmarks and meaning of life of the boys and girls. CONCLUSION: Conclusions: The obtained data demonstrate that implementation of the program of psychophysiological effects on the body, psychohygienic correction of personality development processes and improvement of the quality of life of pupils and students, which includes: study of the level of development of psychophysiological functions, personality characteristics and indicators of the quality of life in each of the participants as well as taking into account the leading areas of their development within certain frameworks of educational process (the milestone of psychodiagnostics and assessment of the level of development of psychophysiological functions and personality traits); performing a set of exercises to relieve muscle spasms, isometric and respiratory gymnastics, as well as exercises of asymmetric gymnastics (the milestone of physical impact); application of psychophysiological component (the milestone of psychophysiological influence); introduction of a psychohygienic component (the milestone of psychohygienic correction) serves the basis for creating the foundation for activating positive changes in the peculiarities of psychophysiological and mental adaptation and characteristics of the quality of life of modern youth at educational institutions of various types.