Relevance. Tuberculosis still remains one of the most serious public health problems worldwide. In Republic of Tyva, despite the ongoing anti-tuberculosis measures, the epidemiological situation remains unfavorable.
Objectives. To analyze epidemiological indicators for the period from 2014 to 2023 in Republic of Tyva and set goals to stabilize the epidemiological situation of tuberculosis in Republic of Tyva
Materials and methods. A retrospective analysis of the morbidity, mortality, and prevalence of tuberculosis among the population over the past 10 years was carried out based on statistical data and market reports of the tuberculosis dispensary (form 2-TB, Order of the Ministry of Health of the Russian Federation No. 50 dated 02/13/2004 for 2014-2023, "Main indicators of tuberculosis activity in the Siberian and Far Eastern Federal Districts" (statistical materials) for 2014-2023, market reports for 2014-2023. GBUZ RT "Tuberculosis dispensary" of the Ministry of Health of Republic of Tyva).
Results. The analysis showed that in Republic of Tuva there is a tendency to decrease the mortality rate (per 100,000 population) from 54.5 in 2014 to 25.8 in 2023 (a decrease of 52%). Despite this, the mortality rate from tuberculosis in Republic of Tyva exceeds that in the Russian Federation by 87%. During the period from 2014 to 2020, the indicators of general (from 170.0 to 86.1) and child morbidity (from 30.5 to 25.4) decreased. As you know, 2020 fell on the COVID-19 pandemic, when all preventive measures were minimized. In Republic of Tyva, since 2021, there has been an increase in general and child morbidity and in 2023 amounted to 153.8 and 126.3 per 100,000 population, respectively. The highest child morbidity in the Russian Federation and the Siberian Federal District is registered in Republic of Tyva – 126.3 per 100 thousand children in 2023.
Conclusions. Based on the results of the analysis, the effectiveness of the work of the phthisiological service of Republic of Tyva was studied and evaluated, positive dynamics in terms of tuberculosis mortality in the region was noted against the background of the implementation of the regional tuberculosis control program and further steps were outlined for its implementation.

Relevance. Sexually transmitted infections are among the most socially significant diseases and are widespread, severe consequences for the patient's body, their complications lead to violations of reproductive health in women and men, to severe congenital diseases in children.
Purpose. Analysis of the dynamics of the incidence rates of sexually transmitted infections (gonococcal infection, trichomonosis, chlamydia infection, anogenital herpes virus infection and anogenital venereal warts) in Republic of Tyva for 2019-2023.
Results. In 2019-2022 in Republic of Tyva there was a significant incidence of gonococcal infection, the incidence rates exceeded those in the Siberian Federal District and the Russian Federation by 6-9 times, and in 2023 there is a decrease in the incidence of gonorrhea by 53.1%, compared to 2022. The incidence of chlamydia in the Republic of Tyva from 2019 gradually decreased until 2021, but from 2022 there is an increase of almost 2-fold (from 30.6 to 57.9 per 100 thousand population). In recent years, there has been a decrease in the incidence of urogenital trichomoniasis from 114.8 in 2019 to 46.8 in 2023, and the incidence of anogenital herpetic infection was lower than in the Russian Federation and the Siberian Federal District, but in 2023 there was an increase from 7.1 to 11.0, which is 35.4% higher than in 2022, for the incidence of anogenital venereal warts in Republic of Tyva there is a decrease from 4.9 in 2019 to 0 cases in 2021, and further incidence of 2.1 and 1.8 cases in 2022 and 2023, which is significantly lower than the incidence rates in the Russian Federation and the Siberian Federal District. However, these indicators do not reflect the true incidence rate and are the result of incomplete registration of new cases of the disease.
Conclusion. Analysis of the dynamics of the morbidity rates of sexually transmitted infections shows that comprehensive measures are needed for effective treatment in accordance with clinical recommendations, with compliance with the drug regimen, exclusion of re-infection, control over the occurrence of adverse drug reactions, repeated control studies and prevention, which includes informing the population about the modes of transmission of sexually transmitted infections and their consequences, exclusion of accidental sexually transmitted infections and their consequences.

Relevance. One of the priority areas of work of the Ministry of Health of Republic of Tuva and subordinate medical organisations has become the formation of a unified system of public health promotion.
Purpose. To analyse the results of work on the formation of the public health system in Republic of Tyva. Results. The system of public health is based on a substantial instrument regional, municipal and corporate programmes of public health, which implement tasks and measures to reduce mortality from controllable causes. In Republic of Tyva, over the 6 years of the implementation of the regional project "Strengthening public health" of the national project "Demography", a system for strengthening public health has been formed. An infrastructure has been created to strengthen public health – the Republican Center for Public Health and Medical Prevention of Republic of Tyva, which is based on public health technologies: strategic planning, monitoring of risk factors, development, implementation and monitoring of municipal and corporate public health programs. The Republic of Tyva is rich in recreational resources. Medicinal springs, the so-called Arzhaans, brine and therapeutic mud of salt lakes have been used by the population of the republic for the treatment of various diseases. The age-old traditions of the use of natural factors by the local population for therapeutic and preventive purposes were introduced into the plan of the corporate program "Healthy lifestyle and positive-a successful team!" in Bai-Taiginsky kozhuun. Bai-Taiga Central Kozhuun Hospital was recognized by the Ministry of Health of Republic of Tyva as the Best practice of Republic of Tyva in 2024.
Conclusion. The implementation of the regional project "Strengthening public health" of the national project "Demography" in Republic of Tyva has formed a modern system for strengthening public health of the population of the republic with the successful use of wellness tours in healing springs (arzhaans) in the summer as part of corporate and municipal programs to strengthen public health. The new Republican Centre for Public Health and Medical Prevention, which has been established, is responsible for the implementation of these programmes.

Relevance. Cancer incidence is an important health problem, continues to grow worldwide and ranks second in the structure of morbidity after cardiovascular diseases. According to Rosstat, from 2013 to 2023 in Russia, the average annual growth rate of malignant neoplasms is 1.18%, and the increase over a 10-year period reached 12.64%. This is primarily due to the development of medicine, improved diagnosis and accounting of diseases. Purposes. To analyze the performance of immunohistochemical studies in the Republic of Tyva in 2023-2024. Materials and methods. Immunohistochemical studies were performed in 218 patients using 8 clones of antibodies to estrogen and progesterone receptors, Cytokeratin 5 and 7, HER2/NEU, Ki-67, TTF1 and p63.
Results. From 2023 to 2024, 128 immunohistochemical studies of newly diagnosed breast cancer in women aged 36 to 86 years were performed. In the differential diagnosis of malignant and benign breast formations, only in 24% of cases the initial signs of cancer invasion in situ were detected. In 21 patients with malignant neoplasms of the gastrointestinal tract, the HER2 status was negative. In all 19 cases of lung cancer, adenocarcinoma was more common than squamous cell carcinoma.
Conclusions. In 2023-2024, in the practical activities of the State Medical Institution of the Republic of Tyva "Republican Oncological Dispensary", there has been a significant increase in both the number of immunohistochemical studies performed and the number of patients to whom they were performed. The obtained data make it possible to determine the immune phenotype of the tumor, which plays an important role in choosing a treatment strategy in the practical activities of the State Medical Institution of Republic of Tyva "Republican Oncological Dispensary".

Relevance. The problems of infectious pathology and today have not lost their relevance. Infectious diseases, including new ones, are a threat to humanity, as they cause one third of the total annual mortality in the world. Objectives. To study the current problems of infectious pathology in Republic of Tyva and the reasons for high morbidity rates.
Materials and methods. The data of the annual statistical report of infectious disease specialists of Republic of Tyva (Form 2 “Information on infectious and parasitic diseases”) and outpatient records of patients registered in the dispensary office were analyzed.
Results. The Republic of Tuva has consistently high annual incidence rates for a number of infectious diseases, and is also an endemic region for brucellosis, tick-borne infections, chronic viral hepatitis, and acute intestinal infections, with incidence rates higher than in the Russian Federation. For chronic hepatitis C, the incidence rates in Tuva are lower than in the Russian Federation and the Siberian Federal District due to low detection of the disease. The most affected group is adults from 40 to 70 years of age and the gender structure is dominated by women 57.8%. Annually in Republic of Tyva there are high mortality rates from diseases of digestive organs, including 50% of liver cirrhosis (including 35% of liver cirrhosis of viral etiology B, C, D).
Conclusions. The main goal remains elimination of chronic hepatitis C and reduction of incidence rates of chronic hepatitis B with Delta hepatitis. It is necessary to strengthen the work on laboratory and clinical diagnostics in Central Kozhuun Hospitals of Republic of Tyva, to improve the quality of medical care for patients with infectious diseases by district pediatricians, prevention of infectious diseases (informing the population about compliance with sanitary and epidemiological regime starting from infancy, the importance of vaccine prophylaxis) and improving the quality of telemedicine and medical care for patients with infectious pathologies (viral hepatitis, HIV infections, acute respiratory viral infections, acute respiratory viral infections, acute respiratory viral infections, and acute respiratory viral infections).

Relevance. In modern society, the mobility of the population, in particular the younger generation, is increasing. Young people are the most dynamic social group, which is open to new opportunities and directions. The relevance of studying the migration intentions of Tuvan youth is due to the fact that 31.7% of the population of Republic of Tyva are young people aged 14 to 35. The study of the migration intentions of young people helps to determine migration movements, motives and goals of migration.
Materials and methods. In June 2023, a sociological study was conducted by order of the Agency for Youth Affairs of Republic of Tyva. The research method was a mass survey of young people aged 14 to 35. The survey involved 1,503 people living in Kyzyl (34.9%), Ak-Dovurak (5.9%), 17 districts of Republic of Tyva (58.4%), as well as young people living outside the republic (0.8%).
Results. About half of the respondents expressed a desire to move to live outside the republic 42.6%. Every third respondent prefers to live and work in the republic 28.4%. 16.3% of young people would like to change their place of residence within the republic, among them the main share is rural youth. The main reasons for the migration of the younger generation are the search for work with a decent salary, obtaining higher and secondary specialized education, difficulties in acquiring real estate in the republic.
Conclusion. Migration sentiments among young people are quite high, about half of the survey participants are focused on moving outside the republic. The implementation of migration intentions of young people may lead to the threat of outflow of the young working population, which may entail serious economic and social consequences. Migration policy should be aimed at supporting young people in employment, solving housing problems, increasing the availability of social services, which will significantly reduce the outflow of young specialists outside the republic.

Relevance. In Republic of Tyva the complex medico-social-psychological support of participants of the spetsial'noi voennoi operatsii (SVO) and members of their families is an actual topic for today in Tuva.
Objective. To analyze medico-social-psychological problems of SVO participants and their family members in Republic of Tyva.
Materials and Methods. To analyze medical and social-psychological problems of the participants of SVO and their family members, methods of inclusive observation and interviews were used. 78 people, including servicemen 26 people, their spouses 20 people, mothers 32 people, from all kozhuuns of Republic of Tyva (except for the remote kozhuun Tere-Khol) and experts working with them within their competence took part in the interviews.
Results. In Republic of Tyva, the regional branch of the “Zashchitniki Otechestva” fund is active as a social institution, providing social, legal, informational and psychological assistance to participants in the SVO and their families. It should also be noted that the regional public organization “Idegel” under the motto “Rodstvenniki uchastnikov spetsial'noi voennoi operatsii – ne odni!” and the “Edinyi koordinatsionnyi tsentr po rozysku propavshikh uchastnikov spetsial'noi voennoi operatsii pri Pravitel'stve Respubliki Tyva” are actively working. The interviews also revealed problems in providing medical care for the health conditions of servicemen, when they could not get to see a doctor in all medical organizations. Federal and regional levels of support measures for the participants of the SVO and their family members in Republic of Tyva were identified.
Conclusion. For all participants of SVO and their family members, as well as specialists who work with this category medical-social-psychological assistance, organized and provided at the levels, both federal and regional, will provide them with timely psychological immunity and stress resistance of the population of Republic of Tyva.