This study was carried out in order to investigating the effect of travelling on the transmission of tuberculosis from high- to low-burden TB countries. Mycobacteria samples isolated from patients of distinct and relatively co-related countries (Azerbaijan Republic and Tabriz [located in the northwest of Iran]) were analyzed through 15 loci MIRU-VNTR typing method. PCR was done using special primers for each of the loci; then the number of allele repeats for all loci were determined by the size of their fragments. Finally, the created numeric patterns for each isolate were analyzed and clustered, using MIRU-VNTRplus.org website. All 119 isolates dispersing at 106 distinct patterns were composed of 10 clusters with 23 members and 96 unique patterns. Nine and five loci had high and moderate discriminatory power, respectively, but only one of them was poor in clustering. The study showed that 89.08% of TB cases involved resulted from the reactivation pattern and 10.92% were related to ongoing transmission. Although Azerbaijan Republic is a higher-burden TB region than Tabriz and Azerbaijan people make frequent tours to Tabriz to receive low or free medical services, the findings showed no TB transmission from the regions at least during the year of the study.
Background: Republic of Azerbaijan and Iran are two neighboring countries with high amount of travelling between them, different rates of TB and its resistance. These relationships could complicate the controlling of tuberculosis programs. Objective: The study was conducted to determine the prevalence of tuberculosis (TB) resistance and its risk factors in the two geographically co-related regions. Method: A total of 119Mycobacterium tuberculosis isolates from the patients of the target regions (Azerbaijan Rep. and Tabriz, Iran) were examined at the Central Tuberculosis Laboratory in Tabriz, Iran. The cultures and drug susceptibility tests was performed on Lowenstein-Jensen. All the isolates were categorized by MIRU-VNTR molecular method into clustered and un-clustered groups. The clustering as well as demographic data were analyzed to determine the risk factors contributing to TB resistance. The categorical data about the TB resistance were compared using a chi square test. Results: 27.8 percent of isolates were resistant at least to one of the 1st line of anti-tuberculosis drugs. The prevalence of any drug resistance and MDR were 64.6 and 17.9 percent respectively for Azari isolates, where the rate of resistance to rifampin and isoniazid was higher than streptomycin and ethambutol. The corresponding figures for the isolates from Tabriz were 16.9 and 3.3 percent respectively. Conclusions: The results of this comparative and cross-sectional study showed statistically significant differences in TB resistance between the isolates from the patients of Azerbaijan Rep. and Iran. According to the results, the rate of resistance to RMP, INH, and MDR was higher in Azerbaijan; consequently, nationality could be regarded as a risk factor of MDR, resistance to RMP and INH but not to SM and ETB. Other studied parameters did not contribute to TB resistance. Bangladesh Journal of Medical Science Vol.18(1) 2019 p.36-41
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