Drug-resistant tuberculosis and HIV in Ukraine: a threatening convergence of two epidemics?
Abstract:OBJECTIVE: To investigate anti-tuberculosis (TB) drug resistance rates in Donetsk Oblast, Ukraine, and to explore the association between the epidemics of human immunodeficiency virus (HIV) and multidrug-resistant TB (MDR-TB).
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: July 1, 2008
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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