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Free Content In the European Union, TB patients from former Soviet countries have a high risk of multidrug resistance

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SETTING: Fourteen countries of the European Union (EU).

OBJECTIVE: To explore determinants of resistance to isoniazid and rifampicin (multidrug-resistant tuberculosis [MDR-TB]) among tuberculosis (TB) patients in the EU.

DESIGN: Pooled TB case notification data for 2003 from the Baltic States (Estonia, Latvia, Lithuania) and Austria, Belgium, the Czech Republic, Denmark, Finland, Germany, Luxembourg, The Netherlands, Slovenia, Sweden and the UK were investigated using bivariate and multivariable analysis.

RESULTS: Of 12109 cases with data, MDR-TB occurred in 709 cases, 91% of whom were from countries of the former Soviet Union (FSU), including the Baltic States. At multivariable analysis, MDR-TB was strongly associated with previous treatment in both Baltic and non-Baltic countries (adjusted OR 9.5 and 6.4, respectively), and inversely related to age >64 years (OR 0.4 and 0.2). In non-Baltic countries, MDR-TB was more strongly related to origin from the FSU (OR 19.7, reference non-Baltic EU) than from other regions (up to OR 2.3). Among cases pooled from all countries, provenance from the FSU was very strongly linked to MDR-TB in both previously untreated (OR 24.9) and previously treated (OR 53.7) cases.

CONCLUSION: Within a context of increasing mobility, public health workers should be aware of a higher risk for MDR-TB among patients from the FSU as well as among patients previously treated for TB.

Keywords: European Union; former Soviet Union; multidrug-resistant tuberculosis; multivariable analysis

Document Type: Regular Paper

Affiliations: EuroTB, Department of Infectious Diseases, Institut de Veille Sanitaire, Saint-Maurice, France

Publication date: 2006-09-01

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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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