Treatment of Tuberculosis in South Kazakhstan: Clinical and Economical Aspects

Abstract

Background and Objective. Since 1990, the tuberculosis incidence rate in Eastern Europe and post-Soviet republics has been increasing in many countries including Kazakhstan. This problem is particularly important in Kazakhstan regions with limited financial resources, among them – in South Kazakhstan province. The aim of this study was to investigate the main clinical and antibiotic-related economic aspects of tuberculosis treatment in South Kazakhstan province. Material and Methods. In total, 502 patients participated in the study. They were hospitalized to the tuberculosis dispensary of Sayram district (South Kazakhstan province) in 2007–2013. Statistical analysis included logistic regression for better treatment outcomes and analysis of antibiotic treatment costs. Results. Two-thirds of patients had infiltrative tuberculosis (67%). Positive treatment outcomes were determined in 85% of cases. The patients were mostly treated with cycloserine, protionamide, capreomycin, and ofloxacin. The majority of antibiotic costs were related to the treatment with capreomycin. In case of the positive results of the test for Mycobacterium tuberculosis, antibiotic expenses were almost 3 times greater than in case of negative test results (P<0.001). Conclusions. The majority of patients had extensively drug-resistant tuberculosis. The negative results of the test for Mycobacterium tuberculosis at discharge were not related to pretreatment factors. Antibiotic-related costs were significantly higher in case of the positive results of the test of Mycobacterium tuberculosis, but were not associated with gender, residence place, hospitalization recurrence, or main blood test results before treatment.

Epidemiology of tuberculosis in Kazakhstan: data from the Unified National Electronic Healthcare System 2014–2019

“…Existing studies have been conducted covering only limited disperse geographic regions. [7][8][9][10][11] The digitalisation of the national healthcare system and the establishment of the UNEHS over the last decade make it feasible to conduct nationwide large-scale epidemiological studies in Kazakhstan. [12][13][14] Therefore, the objective of this in-depth epidemiological study is to estimate the incidence and mortality rates of TB in Kazakhstan, using large-scale administrative health data records between 2014 and 2019, available in the UNEHS database.…”

“…Regardless of the public health impact of TB, there are limited comprehensive reports and publications on the epidemiology of TB in Kazakhstan. Existing studies have been conducted covering only limited disperse geographic regions 7–11. The digitalisation of the national healthcare system and the establishment of the UNEHS over the last decade make it feasible to conduct nationwide large-scale epidemiological studies in Kazakhstan 12–14…”

Facile Fabrication of Composite Scaffolds for Long-Term Controlled Dual Drug Release

“…In addition to the first-line antituberculosis drugs such as isoniazid (INH), rifampicin (RFP), pyrazinamide and ethambutol, others like p-aminosalicylic acid, ethionamide, protionamide and cycloserine are also included for the multiple-drugs therapy of bone TB [18][19][20][21][22][23]. ese drugs can be classified by solubility into two categories of water-soluble and oil-soluble.…”