Drug-resistant tuberculosis and HIV in Ukraine: a threatening convergence of two epidemics?
METHODS: All consecutive newly diagnosed and previously treated patients with sputum smear-positive TB presenting to all TB units in Donetsk Oblast over 12 months were invited to take part in the study. A total of 1293 and 203 patients with TB were tested for HIV and MDR-TB in the civilian and penitentiary sectors, respectively.
RESULTS: Of those enrolled for the study, 307 were HIV-positive, 379 had MDR-TB, and 97 had MDR-TB and HIV co-infection. MDR-TB rates in the civilian sector were respectively 15.5% (95%CI 13.1–17.8) and 41.5% (95%CI 36.4–46.5) in newly diagnosed and previously treated TB patients. Among prisoners, MDR-TB rates were 21.8% (95%CI 12.4–31.2) in new cases and 52.8% (95%CI 43.9–61.7) in previously treated TB cases. HIV status was significantly associated with MDR-TB (OR 1.7, 95%CI 1.3–2.3).
CONCLUSIONS: High MDR-TB rates and a positive association between MDR-TB and HIV epidemics were found in Donetsk Oblast. Urgent measures to improve HIV prevention, control of drug-resistant TB and collaboration between HIV and TB control activities need to be implemented without further delay.
Document Type: Regular Paper
Affiliations: 1: Project Office, World Health Organization, Donetsk, Ukraine 2: Country Office, World Health Organization, Kiev, Ukraine 3: Donetsk State Medical University, Donetsk, Ukraine 4: Donetsk Tuberculosis Reference Laboratory, Donetsk, Ukraine 5: Institut für Mikrobiologie und Labordiagnostik, Asklepios Fachkliniken München-Gauting, Gauting, Germany 6: European Regional Office, World Health Organization, Copenhagen, Denmark 7: World Health Organization, Geneva, Switzerland
Publication date: 2008-07-01
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