Free Content Drug-resistant pulmonary tuberculosis in Israel, a society of immigrants: 1985–1994

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Abstract:

SETTING AND OBJECTIVES: Drug-resistant tuberculosis was uncommon in Israel until 1985, when the waves of immigration began. We studied the incidence and clinical course of resistant pulmonary tuberculosis nationwide.

DESIGN: Isolates of Mycobacterium tuberculosis between 1985 and 1994 were surveyed. Data on 150 patients with resistance and 110 patients with drug-sensitive disease were reviewed. Ethnic origin, type of resistance, radiological findings and outcome were analysed.

RESULTS: In total, 16.7% of the isolates showed resistance to at least one drug; 58% had resistance to multiple drugs. In 67% of the patients the resistance was primary. Most patients were immigrants from the former USSR and from Ethiopia; none were Israeli-born Jews. Mortality with resistance was 10%, and was highest (14%) with multiple drug resistance. Mortality among drug-resistant cases was lowest (3%) among Ethiopian Jews. Cavities and extensive disease were more common with drug resistance.

CONCLUSION: Drug resistance has become relatively common in Israel due to immigration from the former USSR and Ethiopia. It is more extensive radiologically and carries a poorer outcome.

Keywords: mortality; outcome; primary and secondary resistance; radiographic findings

Document Type: Regular Paper

Affiliations: 1: Department of Radiology, Haddasha University Medical Center, Jerusalem, Israel 2: Pulmonary Institute, Tel-Aviv University, Tel-Hashomer, Israel 3: Department of Radiology, Sheba Medical Center, Tel-Aviv University, Tel-Hashomer, Israel 4: Shmuel Haroffe Medical Center, Department of Respiratory Diseases, Beer Jackob, Israel 5: Ministry of Health, Mycobacterium Reference Laboratory, Tel-Aviv, Israel 6: Haddasah Hebrew University Medical School, Jerusalem, Israel

Publication date: August 1, 1999

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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