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Open Access Tuberculosis among migrants in Bishkek, the capital of the Kyrgyz Republic

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Setting: Twenty-two first-line, two second-line and one tertiary health facility in Bishkek, the capital of Kyrgyzstan.

Objectives: Among migrants, a marginalised population at risk for acquiring and transmitting tuberculosis (TB), we determined the proportion with TB among all registered TB cases. For those registered at primary-level facilities, we then reported on their demographic and clinical profiles and TB treatment outcomes.

Design: This was a retrospective cohort analysis of 2012–2013 programme data.

Results: Of 2153 TB patients registered in all health facilities, 969 (45%) were migrants, of whom 454 were registered in first-line facilities. Of these, 27% were cross-border migrants, 50% had infectious TB and 12% had drug-resistant TB. Treatment success was 74% for new cases and 44% for retreatment TB (the World Health Organization target is 85%). Failure in new and retreatment TB patients was respectively 8% and 25%. Twenty-six individuals started on a first-line anti-tuberculosis regimen failed due to multidrug-resistant TB. Eight (25%) of 32 individuals on a retreatment TB regimen also failed. Loss to follow-up was 10% for new and 19% for retreatment TB.

Conclusion: Migrants constituted almost half of all TB patients, drug resistance is prevalent and treatment outcomes unsatisfactory. Fostering inter-country collaboration and prioritising rapid TB diagnostics (Xpert® MTB/RIF) and innovative ways forward for improving treatment outcomes is urgent.
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Keywords: MDR-TB; SORT IT; migration; operational research; treatment outcomes

Document Type: Research Article

Affiliations: 1: National Center of Phthisiology, Bishkek, Kyrgyz Republic 2: Alliance for Public Health, Kyiv, Ukraine 3: Médecins Sans Frontières, Brussels Operational Centre, City of Luxembourg, Luxembourg 4: National Tuberculosis Control Center, Ministry of Health of Armenia, Yerevan, Armenia 5: Centers for Disease Control and Prevention, Almaty, Kazakhstan 6: World Health Organization Regional Office for Europe, Copenhagen, Denmark

Publication date: September 21, 2017

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  • Public Health Action (PHA), The Union's quarterly open access on-line journal, provides a platform for its mission 'Health solutions for the poor'. PHA addresses the need for show-casing operational research that addresses issues in health systems and services. It publishes high-quality scientific research that provides new knowledge to improve access, equity, quality and efficiency of health systems and services.

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