Involving community partners in the management of tuberculosis among drug users

Risk Factors for Drug-Resistant Tuberculosis

“…Intravenous drug use was also identified as a significant risk factor by other authors [12] [25]. Possible explanations include late diagnosis, poor compliance with treatment, and treatment default [26] [27]. Compliance is known to be problematic in such groups [26] [27].…”

“…Possible explanations include late diagnosis, poor compliance with treatment, and treatment default [26] [27]. Compliance is known to be problematic in such groups [26] [27]. Studies have demonstrated the deleterious effects of drug use on the immune system [27].…”

“…Although drug-resistant TB can be transmitted between individuals (primary resistance), most cases arise after inadequate treatment allowing a drug-resistant strain to become dominant [10]. The use of directly observed therapy (DOT) is highly recommended to promote treatment adherence [16] [26]. Recent studies suggest that resistance is less likely to develop or to be transmitted when TB patients are under DOT [16] [28].…”

Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

“…Twelve of the included studies focussed on migrants, [29][30][31][32][33][34][35][36]38,41,43,45 of which one focussed on children. 41 Three studies focussed on mixed hard-to-reach populations; 39, 42,46 two on drug users; 40,44 one on people living with HIV 47 and one on homeless people. 37 None of the included studies focussed on sex workers.…”

“…Eight studies were conducted in the EU, two in the United Kingdom (UK), 39,42 one in Estonia, 44 one in France, 37 one in Germany, 46 one in Italy, 47 one in Norway 32 and one in Portugal. 40 The remaining eleven studies were conducted outside the EU, eight in the United States (US), 29,31,[33][34][35][36]41,43 two in Israel 30,38 and one in Switzerland. 45 The interventions to improve identification of TB applied active case finding by using (mobile) CXR, 30,[37][38][39]42 symptom-based questionnaire, 45 TST or IGRA 31,36,41 ; adding sputum smear 34,39 or sputum culture 29,33,43 to a screening algorithm; and active referral to a TB clinic.…”