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Free Content The risk of MDR-TB and polyresistant tuberculosis among the civilian population of Tomsk city, Siberia, 1999

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SETTING: Tomsk, Siberia, Russian Federation.

OBJECTIVE: To evaluate the relationship between TB susceptibility patterns and risk factors among a civilian cohort of new cases in Tomsk city in 1999.

DESIGN: Population-based study. The association between MDR-TB or PROMDR-TB, defined as resistance to isoniazid and rifampicin (MDR) or to isoniazid, ethambutol, and streptomycin (rifampicin mono-sensitive), and hypothesized risk factors was determined. Univariable analysis with and without stratification for history of incarceration and stepwise logistic regression modeling were used.

RESULTS: Overall, 49.6% of participants were infected with a Mycobacterium tuberculosis strain resistant to at least one prescribed anti-tuberculosis medication. PROMDR-TB and MDR-TB were prevalent in 17.2% and 13.1% of participants, respectively. Logistic regression modeling indicated that good residence (OR 3.1, 95%CI 1.4–6.9), treatment default (OR 4.4, 95%CI 2.1–9.3) and psychological disorder (OR 3.3, 95%CI 1.0–10.9) were associated with PROMDR-TB. Both good residence (OR 2.6, 95%CI 1.1–6.0) and treatment default (OR 5.3, 95%CI 2.4–11.6) were associated with MDR-TB. History of incarceration was not found to be significant.

CONCLUSION: Our findings support the hypothesis that drug-resistant disease among the Tomsk city population is not directly linked to history of incarceration, nor is it an extension of drug resistance in prisons. Rather, drug resistance in the civil sector reflects problems specific to the sector itself.

Keywords: Russia, Siberia; TB control; multidrug resistance; prisons; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of General Internal Medicine, UAB School of Medicine, Birmingham, Alabama, USA; and Department of Epidemiology and International Health, UAB School of Public Health, Birmingham, Alabama, USA 2: Department of Epidemiology and International Health, UAB School of Public Health, Birmingham, Alabama, USA 3: Tomsk Oblast Tuberculosis Service, Tomsk, Siberia, Russian Federation 4: Medical Emergency Relief International (MERLIN), London, United Kingdom

Publication date: September 1, 2003

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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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