Multidrug-resistant tuberculosis in Uzbekistan: results of a nationwide survey, 2010 to 2011

Ulmasova, Dilrabo; Uzakova, G.; Tillyashayhov, M N; Turaev, Laziz; Gemert, Wayne van; Hoffmann, Harald; Zignol, Matteo; Kremer, Kristin; Gombogaram, T; Gadoev, Jamshid; Cros, Philipp du; Muslimova, N; Jalolov, Avazbek; Dadu, Andrei; Colombani, Pierpaolo de; Telnov, Oleksander; Slizkiy, A; Kholikulov, B; Dara, Masoud; Falzon, Dennis

doi:10.2807/1560-7917.es2013.18.42.20609

Cited by 45 publications

(41 citation statements)

References 13 publications

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“…Ndung'u et al 8 showed 66.5% of the MDR-TB study population in Nairobi were unemployed and 79.4% earned less than 100 USD per month. MDR-TB estimates for Uzbekistan were among the highest reported in former Soviet Union countries which were attributed to factors like imprisonment, unemployment and previous treatment with TB as shown by Ulmasova et al 7 . Primarily resistant TB strains, malnutrition, poverty, overcrowding, poor hygiene, decreased health care seeking attitude formed a vicious cycle of agent-host-environment.…”

Section: Discussionmentioning

confidence: 94%

“…A study in west Australia by Francis et al 6 showed the median age of the MDR-TB patients were 26 years. However, in separate studies Ulmasova et al 7 and Ndung'u et al 8 showed that MDR-TB was significantly associated with age less than 45 years in Uzbekistan and Nairobi (88.7%) respectively. Malnutrition since childhood leading to weakened immune response, made the younger population more susceptible to MDR-TB in developing countries.…”

Section: Discussionmentioning

confidence: 99%

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Drug resistance pattern, related socio- demographic factors and preventive practices among MDR-TB patients: An experience from a tertiary care setting

Manna¹

2014

IOSRJDMS

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Drug resistance pattern, related socio- demographic factors and preventive practices among MDR-TB patients: An experience from a tertiary care setting

Manna¹

2014

IOSRJDMS

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“…However, in some settings, mainly located in Eastern Europe and Central Asia, the proportions are further amplified (up to 50% versus 20%, respectively) [1,[6][7][8]. The detection capacity increased between 2011 and 2012 (42%); although, unfortunately it was not followed by an increased treatment capacity.…”

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confidence: 99%

Linezolid to treat MDR-/XDR-tuberculosis: available evidence and future scenarios

2014

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@ERSpublicationsNew experimental evidence on anti-TB regimes based on low-efficacious linezolid dosage to treat XDR-TB patients http://ow.ly/C9YpZThe figures provided by the World Health Organization (WHO) in its 2013 global tuberculosis (TB) report are remarkable; TB continues to represent a significant clinical and public health problem worldwide [1]. The successes obtained by implementing and scaling-up the WHO public health strategies between 1995 and 2012 (i.e. 22 million lives saved and 56 million patients successfully treated) are outstanding. However, in spite of the dramatic decrease in incidence, prevalence and mortality [1] much needs to be done, and the new WHO post-2015 strategy (which is focused on the concept of TB elimination) is providing further guidance [2-4].Among the core factors challenging the TB control and elimination efforts, the most significant are probably the persistent evolution of TB/HIV co-infection and the emergence and spread of drug-resistant TB [1], which has become an unstoppable hurricane [1,5]. The estimated burden of multidrug-resistant (MDR)-TB (i.e. tuberculosis caused by Mycobacterium tuberculosis strains resistant to at least two of the most potent anti-TB drugs, isoniazid and rifampicin) is worrisome. Less than one quarter of the individuals estimated to have MDR-TB were properly diagnosed in 2012; the estimated incidence and mortality are equal to 450 000 and 170 000, respectively.As demonstrated in other infectious diseases, the most significant burden is detected in previously treated rather than newly diagnosed TB cases (∼20% versus 3.6%, respectively). However, in some settings, mainly located in Eastern Europe and Central Asia, the proportions are further amplified (up to 50% versus 20%, respectively) [1,[6][7][8]. The detection capacity increased between 2011 and 2012 (42%); although, unfortunately it was not followed by an increased treatment capacity. Out of 94 000 MDR-TB patients identified in 2012 only 82% (equivalent to 77 000 patients) were exposed to (appropriate) regimens. Furthermore, almost 10% of the MDR-TB cohort showed a disease caused by M. tuberculosis strains characterised by a worse resistance pattern, known as extensively drug-resistant (XDR)-TB (i.e. MDR-TB with further resistance to any fluoroquinolones and at least one injectable second-line drug, amikacin, capremycin or kanamycin). Its geographical distribution is almost global (at least one case in 92 countries in 2012) [1]. Whenever there was diagnostic capacity it has been inevitably detected.If we look at the treatment outcomes of these cases, the picture is even worse. Only 48% of the individuals with MDR-TB belonging to the 2010 cohort were successfully treated worldwide (i.e. microbiologically cured or completed treatment alone), whereas hundreds of patients died or defaulted. Only 31.8% (34 out of 107) of countries reported an expected treatment success rate ≥75% among their notified MDR-TB cases [1,9].

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“…However, in some settings (Eastern Europe and Central Asia), the proportions are further amplified to reach 50% [15][16][17][18].…”

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confidence: 97%

Delamanid (OPC-67683) for treatment of multi-drug-resistant tuberculosis

Sotgiu

Pontali

Centis

et al. 2015

Expert Review of Anti-infective Therapy

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The research and development of delamanid was carried out by Otsuka Pharmaceutical Development and Commercialization (Osaka, Tokyo, Japan). It belongs to the group of nitroimidazoles. It inhibits the synthesis of mycolic acids, crucial component of the cell wall of the Mycobacterium tuberculosis complex. It is insoluble in water and its activity was proven in several in vitro and in vivo studies. Its market approval was obtained in April 2014 in Europe. Its bactericidal activity was demonstrated in individuals with drug-susceptible and drug-resistant tuberculosis (MDR- and XDR-TB). The safety and tolerability profile was good; the notified increased QT interval was not clinically relevant. It was approved for adults but ongoing clinical trials and clinical experiences have been proving its efficacy in the pediatric population.

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Multidrug-resistant tuberculosis in Uzbekistan: results of a nationwide survey, 2010 to 2011

Abstract: Binary file ES_Abstracts_Final_ECDC.txt matches

Cited by 45 publications

References 13 publications

Drug resistance pattern, related socio- demographic factors and preventive practices among MDR-TB patients: An experience from a tertiary care setting

Drug resistance pattern, related socio- demographic factors and preventive practices among MDR-TB patients: An experience from a tertiary care setting

Linezolid to treat MDR-/XDR-tuberculosis: available evidence and future scenarios

Delamanid (OPC-67683) for treatment of multi-drug-resistant tuberculosis

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