Epidemiology of Primary Multidrug-Resistant Tuberculosis, Vladimir Region, Russia

Ershova, Julia; Volchenkov, Grigory; Kaminski, Denise A.; Somova, Tatiana R.; Кузнецова, Т. А.; Kaunetis, Natalia V.; Cegielski, J. Peter; Kurbatova, Ekaterina V.

doi:10.3201/eid2111.150813

Cited by 12 publications

(7 citation statements)

References 6 publications

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“…Our finding was comparable to the results of similar surveys conducted in Ethiopia, 13 China, 14 and Brazil. 15 However, it was lower than studies conducted across the globe, such as Ethiopia (26.9%), 16 South Africa (49%), 17 the eastern coast of China (53.9), 2 Vladimir Region of Russia (73.3%), 18 and reports in a review of data for 30 countries having anti-tuberculosis drug resistance surveillance (31%-82%). 19 This can be due to these countries taking the lion share of the global DR-TB patients and correspondingly increasing the prevalence of a primary form of RR/MDR-TB through increased transmission.…”

Section: Discussionmentioning

confidence: 83%

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Kassa

Merid

Muluneh

2021

IDR

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Background Rifampicin and/or multidrug-resistant tuberculosis (RR/MDR-TB) remains an uncontrolled public health emergency that has been synergized by the recently increased person-to-person transmission in the community as primary RR/MDR-TB, which is defined as RR/MDR-TB in new TB patients with no prior exposure to anti-TB treatment for more than one month. This study aimed to measure the prevalence and associated factors of primary drug-resistance among drug-resistant tuberculosis patients, as evidenced by the Amhara region treatment initiating centers. Methods An institutional-based multicenter cross-sectional study was conducted from September 2010 to December 2017, among 580 RR/MDR-TB patients on the second-line anti-TB drug in the Amhara regional state. Data were collected from patient charts and registration books using a standardized data abstraction sheet. The data were entered using Epi-data 4.2.0.0 and transferred to Stata 14 software for further data management and analysis. A bivariable and multivariable binary logistic model was run subsequently, and finally, a p-value of less than 0.05 with a 95% confidence interval (CI) was used to declare the significance of the explanatory variable. Results The magnitude of primary drug resistance among drug-resistant tuberculosis patients was 15.69% (95% CI: 12.94, 18.89). Alcohol drinking (adjusted odds ratio [AOR] = 0.31, 95% CI: 0.12–0.82), khat chewing (AOR = 4.43; 95% CI: 1.67–11.76), ambulatory and bedridden functional status (AOR = 0.43; 95% CI: 0.24–0.76) and (AOR = 0.41; 95% CI: 0.19–0.91), respectively, positive sputum smear result (AOR = 0.48; 95% CI: 0.26–0.90), and HIV coinfection (AOR= 2.31; 95% CI: 1.31–4.06) remained statistically significant associated factors of primary RR/MDR-TB. Conclusion Primary drug resistance is a public health problem in the study setting. Different behavioral and clinical conditions were significant factors of primary drug-resistant development. Mitigation strategies targeted on the patient’s clinical condition, substance-related behaviors, and universal DST coverage might be very important for early detection and treatment of RR/MDR-TB to prevent community-level transmission.

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Section: Discussionmentioning

confidence: 83%

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Kassa

Merid

Muluneh

2021

IDR

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“…Using prospective cohort design, we assessed impact of Xpert on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir Regional TB Dispensary (the Dispensary), Russia. The Dispensary is a referral center for TB patients in Vladimir region and serves about 25% of all TB patients in the region [ 10 ]. The patients were referred to the Dispensary as presumptive TB patients after visiting primary health care physician or pulmonologist based on symptoms or results of mass TB screening.…”

Section: Methodsmentioning

confidence: 99%

Impact of GeneXpert MTB/RIF® on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir TB dispensary, Russia

et al. 2020

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Background The main advantage of GeneXpert MTB/RIF ® (Xpert) molecular diagnostic technology is the rapid detection of M .tuberculosis DNA and mutations associated with rifampicin (RIF) resistance for timely initiation of appropriate treatment and, consequently, preventing further transmission of the disease. We assessed time to treatment initiation and treatment outcomes of RIF-resistant and RIF-susceptible TB patients diagnosed and treated in Vladimir TB Dispensary, Russia in 2012, before and after implementation of GeneXpert MTB/RIF® diagnostic technology. Methods All adult patients suspected of having TB during February–December 2012 underwent a clinical examination, chest x-ray, microscopy, culture, and phenotypic drug susceptibility testing (DST). Starting August 2012 Xpert diagnostic technology became available in the facility. We used logistic regression to compare treatment outcomes in pre-Xpert and post-Xpert periods. Kaplan-Meier curves and log-rank test were used to compare the time to treatment initiation between the groups. Results Of 402 patients screened for TB during February–December 2012, 338 were diagnosed with TB (280 RIF-susceptible, 58 RIF-resistant). RIF-resistant patients in the post-Xpert group started treatment with second-line drugs (SLD) earlier than those in pre-Xpert group (median 11 vs. 37 days, Log-rank p = 0.02). The hazard ratio for time to SLD treatment initiation was significantly higher in post-Xpert group (HR:2.06; 95%CI:1.09,3.89) compared to pre-Xpert group. Among the 53/58 RIF-resistant TB patients with available treatment outcome, 28 (53%) had successful outcomes (cured/completed treatment) including 15/26 (58%) in post-Xpert group versus 13/27 (48%) in pre-Xpert group. The observed difference, however, was not statistically significant (OR:0.69; 95%CI:0.23,2.06). Among RIF-susceptible TB cases time to treatment initiation was not significantly different between the groups (2 vs. 3 days, Log-rank p = 0.73). Of 252/280 RIF-susceptible TB cases with treatment outcome, 199 (79%) cases had successful outcome including 94/114 (82%) in post-Xpert group versus 105/138 (76%) in pre-Xpert group (OR:0.68; 95%CI:0.36,1.26). Conclusion We observed that availability of Xpert for initial diagnosis significantly reduced the time to SLD treatment for RIF-resistant patients in the Vladimir TB Dispensary. Although implementation of rapid diagnostics did not improve treatment outcomes, early diagnosis of MDR-TB is important for selection of appropriate treatment regimen and prevention of transmission of drug-resistant strains of TB.

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“…Ershova et al observed in their research that out of 60 MDR-TB patients 44 patients were newly diagnosed patients with no previous history of taking anti-TB drugs, which was near about 73 percent of the cohort. 12 This is a clear-cut sign of escalating trends of primary acquired MDR-TB in the community, which is alarming for policy makers.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of multi-drug resistant tuberculosis and factors associated with treatment outcome in three districts of Himachal Pradesh, India

Verma¹,

Singh²,

Shridhar³

et al. 2021

Int J Community Med Public Health

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Background: Tuberculosis (TB) is a leading cause of morbidity and mortality in the world and especially in India. MDR TB has emerged as a major challenge in TB control in India. The prevalence of MDR TB is on the rise in India. We did this study to see the prevalence of MDR TB in 3 districts of Himachal Pradesh and to study the factors affecting treatment outcomes.Methods: The period of the study was from January 2019 to December 2019. We collected data of MDR TB patients from district TB offices of Solan, Bilaspur and Hamirpur. Information from patients was collected through questionnaires while interviews were conducted with district project officer and other health officials and documents, brochures, etc. were collected from Solan, Hamirpur and Bilaspur.Results: Overall prevalence rate of MDR TB in our study was 3.14%. Among new TB cases, the prevalence rate of MDR TB was 2.42% (81/3345), and among old treated cases was 9% (37/411). 31% MDR TB patients were old treated while 69% patients had no previous treatment history. The default rate was low in our study (0.84%) while 8 (6.4%) patients had treatment interruption but for less than 15 days.Conclusions: The prevalence in our study is comparable to the national drug resistance survey. Early detection, timely treatment and contact tracing is vital in decreasing the MDR TB cases. Better supervision, constant monitoring, proper counselling and timely identification and management of adverse effects of the drugs will improve the treatment outcome among MDR TB patients.

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Epidemiology of Primary Multidrug-Resistant Tuberculosis, Vladimir Region, Russia

Cited by 12 publications

References 6 publications

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Khat Chewing and Clinical Conditions Determine the Epidemiology of Primary Drug Resistance Tuberculosis in Amhara Region of Ethiopia: A Multicenter Study

Impact of GeneXpert MTB/RIF® on treatment initiation and outcomes of RIF-resistant and RIF-susceptible TB patients in Vladimir TB dispensary, Russia

Prevalence of multi-drug resistant tuberculosis and factors associated with treatment outcome in three districts of Himachal Pradesh, India

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