Mathematical analysis of the basic parameters was used to trace a trend in the epidemiological situation of tuberculosis in the Tver Region. Unfavorable shifts were noted in the increase of the prevalence, incidence, and mortality of tuberculosis among children and adolescents, and a rise in the reservoir of tuberculous infection. New approaches to improving the epidemiological situation by integrating the phthisiological service and general health care facilities, by enhancing a role of a family physician, by applying informational systems for monitoring the epidemic situation, and by introducing the adapted international strategies, WHO recommendations have been developed for the treatment of patients and tested. It is suggested that the tuberculosis-controlling service should closely interact with governmental bodies, social and religious organizations, and the mass media for the optimization of tuberculosis control at a regional level.