Source: Annual Congress 2002 - Drug resistance in different areas
Disease area: Respiratory infections

Abstract

Setting Médecins Sans Frontières supports tuberculosis (TB) programmes in 6 NIS: in penitentiary system (Siberia), at national level (Abkhazia, N-Karabagh), at regional or district level (Uzbekistan, Turkmenistan, Kazakhstan). Populations covered range from 30,000 to 840,000.
Objectives: Describe treatment outcomes and drug resistance in diverse NIS contexts.
Methods TB programmes were implemented and evaluated according to international recommendations. DST were performed by proportion method in 3 supra-national laboratories.
Results From 1996 to 2001: about 17,000 patients have been treated and 1,000 DST performed. In 1999 success and failure rates for all smear positive patients ranged from 64% (453/706) and 22 (155/706) in Siberia to 82% (45/55) and 9% (5/55) in N-Karabagh. Defaulter rates ranged from 2.5% (3/124) in Turkmenistan to 18% (11/62) in Kazakhstan. Multi-drug resistance (MDR) ratios ranged from 24% (40/165) in Kazakhstan to 4% (4/102) in N-Karabagh. Resistance to isoniazid ranged from 24% (14/58) in Turkmenistan to 59% (98/165) in Kazakhstan.
Discussion These results confirm the disquieting sistaution of resistant TB in NIS both in civil and penitentiary population and the limits of standard short course treatments. They attest the urgent need for an adapted TB control strategy in such contexts and adequate therapy for resistant TB patients.

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Tuberculosis programmes and drug resistance in 6 newly independant states (NIS). Eur Respir J 2002; 20: Suppl. 38, 2559

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