Anti-tuberculosis drug resistance in community and prison patients, Orel Oblast, Russian Federation
OBJECTIVES: To determine baseline levels of anti-tuberculosis drug resistance in Orel Oblast.
DESIGN: Drug susceptibility testing (DST) records from 1 July 1999 to 30 June 2000 for patients with sputum acid-fast bacilli smear-positive pulmonary tuberculosis were reviewed. Treatment and incarceration status were obtained from the tuberculosis register. Patients with 1 month or less of prior treatment were defined as new cases; those previously treated for more than 1 month were defined as retreatment cases.
RESULTS: Of 246 smear-positive isolates, 212 (86%) had DST performed. Of these, 190 (90%) were from new and 22 (10%) from retreatment cases; 171 (81%) were from community and 41 (19%) were from prison patients. Any drug resistance was more common among prison than community patients (44% vs. 30%, P = 0.05). MDR-TB was found in 14 (6.6%) of 212 isolates, and was more prevalent in prison compared with community patients (12% vs. 5%, P = 0.05). Retreatment cases were more likely than new cases to have MDR-TB (prevalence ratio [PR] = 8.5, 95%CI = 3.3–22.3), although the PR was higher for prison than for community retreatment cases (10.0 vs. 5.8).
CONCLUSIONS: New cases with MDR-TB were less prevalent in Orel Oblast compared with other survey sites in Russia. Any drug resistance and MDR-TB were associated with prior treatment, especially in the prison population. Continued monitoring of trends in drug resistance following DOTS implementation is needed.
Document Type: Regular Paper
Affiliations: 1: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 2: Central Tuberculosis Dispensary, Orel, Russian Federation 3: Central Tuberculosis Research Institute, Moscow, Russian Federation 4: Russian Tuberculosis Programme, World Health Organization, Moscow, Russian Federation
Publication date: 2002-09-01
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