The results of 5 years' observation of the epidemiologic situation for tuberculosis in the northwest region of the Russian Federation have shown that tuberculosis prevalence among the rural population is less than in Russia, on the average. There is a tendency towards disappearance of the epidemiologic differences between the rural and urban locality, which enables one to regard tuberculosis as a single epidemiologic problem. At the same time, high level of tuberculosis contingents is maintained in rural settlements, which can be ascribed to the insufficient effectiveness of treatment or dispensary follow-up. A negative influence of social factors also grows. In conditions of the multivariant character of the organization of the public-health service optimization of work can be achieved by the creation of interregional scientific-practical centres.