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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.

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: 21 September 2017

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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