Isoniazid resistance among tuberculosis patients by birth cohort in Germany
OBJECTIVE: To determine the prevalence of isoniazid resistance by year of birth among previously treated and untreated tuberculosis patients by country of birth.
DESIGN: Univariate and multivariate analyses of data on 8658 cases from a nationally representative sample.
RESULTS: The crude prevalence of isoniazid resistance was 2.4% and 9.9% among Germany-born patients respectively without and with a prior treatment history. Among those without a history, there was virtually no difference between quartiles of birth cohorts, while among those with, a large decrease from the oldest to the youngest was observed. Among foreign-born patients, the prevalence of isoniazid resistance increased from 3.8% to 11.8% from the oldest to the youngest among those without, and more than doubled from less than 20% to more than 40% among those with prior treatment.
CONCLUSION: This analysis suggests a remarkably constant and low prevalence of isoniazid resistance among never treated Germany-born patients. In contrast, among the diverse group of foreign-born patients, the prevalence increases appreciably from the oldest to the youngest birth cohorts. This indicates that tuberculosis treatment policies in Germany have been sound and that great care is needed to prevent acquisition of additional resistance among foreign-born patients.
Document Type: Regular Paper
Affiliations: 1: Public Health Center, Wiesbaden, Germany; and the German Central Committee against Tuberculosis, Berlin, Germany 2: German Central Committee against Tuberculosis, Berlin, Germany 3: International Union Against Tuberculosis and Lung Disease, Paris, France
Publication date: 2003-10-01
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.
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