Tuberculosis among migrants in Bishkek, the capital of the Kyrgyz Republic

Гончарова, О. В.; Denisiuk, Olga; Zachariah, Rony; Davtyan, Karapet; Nabirova, Dilyara; Acosta, Colleen; Kadyrov, Abdullaat

doi:10.5588/pha.17.0002

Cited by 3 publications

(5 citation statements)

References 13 publications

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“…In drug-resistant TB, success rates were similar across all groups (71–73%). This figure is an improvement on the success rates of 61–74% reported among migrants in different regions of the Kyrgyz Republic [ 8 , 9 , 22 ]. This observation perhaps means that the NTP pays special attention to the treatment and follow-up of patients with risk factors.…”

Section: Discussionmentioning

confidence: 84%

“…The migrant population includes individuals who migrate within the country (internal migrants) and from neighboring countries (external migrants). A substantial proportion of diagnosed TB patients (45%) in the capital city of Bishkek were migrants in the period 2012–2013 [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Successful TB treatment outcomes among migrants ranged from 71% during the period 2012–2013 in Bishkek city to 74% during the period 2015–2017 in the Chui region, which were lower than the national average (82%), and the WHO recommended a target of 85% at that time [ 8 , 9 , 10 ]. Most of the migrants with TB are Kyrgyz citizens and, therefore, are expected to have access to health care comparable to non-migrants.…”

Section: Introductionmentioning

confidence: 99%

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Delays in Treatment Initiation and Treatment Outcomes in Patients with Tuberculosis in the Kyrgyz Republic: Are There Differences between Migrants and Non-Migrants?

Istamov,

Beglaryan,

Goncharova

et al. 2023

TropicalMed

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Migrants are at increased risk of developing tuberculosis (TB) and have poor treatment outcomes. The National TB program (NTP) of the Kyrgyz Republic recognizes two types of migrants: internal (intra-country) and external (inter-country) migrants. This cohort study compared the characteristics, timeliness of diagnosis and treatment initiation, and treatment outcomes of TB patients (internal migrant vs. external migrant vs. non-migrant) identified during treatment in the country in 2021. The TB treatment register and treatment cards of 5114 patients (156 internal, 430 external, and 4528 non-migrants) were reviewed. Risk factors (unemployment, smoking, alcohol use, and homelessness) were higher (p-value < 0.001) in internal (84%) than in external migrants (66%) and non-migrants (43%). The median delay in seeking care post-symptom onset was longer (p-value= 0.03) in external (30 days) than in internal migrants (21 days) and non-migrants (25 days). Successful treatment outcomes for drug-sensitive TB were higher in internal (89%, p-value = 0.012) and external migrants (86%, p-value = 0.001) than in non-migrants (78%). Internal and external migrants should be separately considered with respect to TB care and monitoring under the NTP. Success rates seem to be high in migrants, but our findings may be biased, as migrants with poor healthcare access may remain undetected and untreated and have undocumented poor outcomes.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delays in Treatment Initiation and Treatment Outcomes in Patients with Tuberculosis in the Kyrgyz Republic: Are There Differences between Migrants and Non-Migrants?

Istamov,

Beglaryan,

Goncharova

et al. 2023

TropicalMed

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“…A PubMed search revealed two previous studies in key populations that used data from the National TB Registry of the Kyrgyz Republic. One study was restricted to migrants [ 6 ] and the other study focused on one region of the country [ 7 ]. To date, there has been no country-wide assessment on who these population groups are, where they come from, and how they fare on TB treatment.…”

Section: Introductionmentioning

confidence: 99%

Triple Priority: TB/HIV Co-Infection and Treatment Outcomes among Key Populations in The Kyrgyz Republic: A National Cohort Study (2018–2022)

Goncharova,

Abrahamyan,

Nair

et al. 2023

TropicalMed

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Background: Improving tuberculosis (TB) care in key populations is an operational research priority in the Kyrgyz Republic. Here, we describe the characteristics of TB/HIV co-infected individuals, their affiliations with key country-wide population groups, and their TB treatment outcomes. Methods: This was a cohort study using national programmatic data (2018–2022). The key population groups included people with increased exposure to TB, limited access to TB services, and increased risk of acquiring TB. Results: Among 693 individuals with TB/HIV co-infection, the majority (58%) of individuals were from two regions of the Kyrgyz Republic (Chui and Bishkek). Eighty-four percent (84%) individuals had one or more affiliations to eight key population groups, with 49% of the individuals affiliated to ≥2 groups and 92% of the individuals were on both antiretroviral treatment and cotrimoxazole preventive therapy. Overall, 406 (59%) of the individuals had successful outcomes and 287 (41%) of the individuals had unsuccessful outcomes. Unsuccessful outcomes increased from 36% (n-39) with TB/HIV alone to 47% (n-86) with affiliations to ≥3 key population groups (P-0.03). Unsuccessful outcomes were associated with co-morbidities (diabetes mellitus and hepatitis B/C), migration, alcohol use, and extrapulmonary TB. Conclusions: For a long time, people with TB/HIV co-infection have been recognized as a “double priority”. Affiliation to key populations accentuates their status to “triple priority”. We advocate for increased attention and equity towards these populations.

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“…These conditions contribute to high exposure to TB, increased risk of recurrence, delay in treatment-seeking, and increased severity of the disease. A recent study in Kyrgyzstan showed that 45% of revealed TB cases were among migrants [10]. Kyrgyzstan offers treatment to TB key populations but there is no published information on the proportions of these populations among TB patients and their treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Who is doing worse? Retrospective cross-sectional study of TB key population treatment outcomes in Kyrgyzstan (2015-2017)

Kozhoyarova

Sargsyan²,

Гончарова

et al. 2020

J Infect Dev Ctries

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Introduction: Tuberculosis (TB) is a global public health problem. The incidence of TB is especially high among TB key populations, such as the homeless, people who use drugs, prisoners, and migrants. The study aimed to assess the associations between affiliation to TB key populations and treatment outcome. Methodology: This retrospective cross-sectional study used data extracted from the National TB Registry of Kyrgyzstan for the region of Chuy (including the city of Bishkek) for 2015–2017. Descriptive statistics was used to summarize the data. Logistic regression was used to assess the associations. Results: The study included 1,526 patients among whom more than half (52.5%) fell into the youngest group (18-35 years old). Migrants were the most highly represented group comprising 67.8% of all TB key populations. Men (63.0%) and patients with pulmonary TB (83.0%) prevailed in the cohort. The proportions of patients who had completed the treatment were high among all the key populations. Logistic regression was used to assess the association between affiliation to a certain TB key population and the TB treatment outcome. Patients who belonged to more than one TB key population were found to have the highest risk of unsuccessful TB treatment outcomes, both in the region of Chuy (OR = 9.9, 95% CI 2.0–48.1, p = 0.04) and the city of Bishkek (OR = 24.9, 95% CI 7.2–86.4, p < 0.001). Conclusion: The homeless, people who use drugs, ex-prisoners, and TB patients who belonged to more than one TB key population were found to have higher risks of unsuccessful TB treatment outcome in comparison to migrants.

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Tuberculosis among migrants in Bishkek, the capital of the Kyrgyz Republic

Cited by 3 publications

References 13 publications

Delays in Treatment Initiation and Treatment Outcomes in Patients with Tuberculosis in the Kyrgyz Republic: Are There Differences between Migrants and Non-Migrants?

Delays in Treatment Initiation and Treatment Outcomes in Patients with Tuberculosis in the Kyrgyz Republic: Are There Differences between Migrants and Non-Migrants?

Triple Priority: TB/HIV Co-Infection and Treatment Outcomes among Key Populations in The Kyrgyz Republic: A National Cohort Study (2018–2022)

Who is doing worse? Retrospective cross-sectional study of TB key population treatment outcomes in Kyrgyzstan (2015-2017)

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