Tuberculosis, drug use and HIV infection in Central Asia: An urgent need for attention

Schluger, Neil W.; El‐Bassel, Nabila; Hermosilla, Sabrina; Terlikbayeva, Assel; Darisheva, Meruyert; Aifah, Angela; Galea, Sandro

doi:10.1016/j.drugalcdep.2013.07.012

Cited by 29 publications

(23 citation statements)

References 28 publications

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“…Although their number is growing, harm reduction services continue to reach only a minority of PWID (FWID in particular) and other vulnerable populations (El-Bassel, Gilbert, et al, 2014), and, as previously noted, OST has been introduced only recently and remains grossly underutilised in this region (Grund, Latypov, & Harris, 2013;Latypov, Bidordinova, & Khachatrian, 2012;Latypov et al, 2014;Parsons et al, 2014;Zabransky et al, 2014). Several authors suggested that integration of TB services, HIV care, and drug treatment is needed urgently for an efficient and coordinated response (Beyrer et al, 2009;Cox et al, 2004;El-Bassel, Gilbert, et al, 2013;Schluger et al, 2013) and efforts towards more integrated service provision are underway in Central Asia, supported by the WHO, ICRC, MSF, PSI and other international organisations (Cox et al, 2004;Grund et al, 2012).…”

Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 92%

“…Likewise, protracted inpatient hospitalisation and isolation at TB hospitals remain the central approach to TB treatment. A remnant of the Soviet (highly centralised and vertical) health care model, drug treatment, HIV prevention services, antiretroviral therapy, TB and hepatitis services remain poorly integrated (El-Bassel, Gilbert, et al, 2013;Grund, Tilenbaeva, Tchitchinadze, Henry, & Usupova, 2012;Schluger et al, 2013;Zabransky et al, 2014). In fact, each of these "pillar institutes" presents a separate medical power structure with separate hierarchies and communication lines.…”

Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 96%

“…TB rates are reportedly "extremely high," with alarmingly high rates of multidrug-resistant tuberculosis (MDR-TB) (Cox et al, 2004;Schluger et al, 2013). Co-occurring rising rates of HIV infection among people who inject drugs (PWID), their sex partners, men who have sex with men, female sex workers and migrant workers raise acute concerns over a "potentially devastating co-epidemic of TB/HIV and MDR-TB/HIV" (El-Bassel, Strathdee, et al, 2013;Schluger et al, 2013). Exceptionally high prevalence of HCV among PWID (Beyrer et al, 2009), very often co-occurring with HIV (Walsh & Maher, 2012) further underlines the menace of a syndemic health emergency in Central Asia.…”

Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 99%

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Illicit drugs in Central Asia: What we know, what we don’t know, and what we need to know

Latypov¹,

Grund

El‐Bassel

et al. 2014

International Journal of Drug Policy

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Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 92%

Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 96%

Section: Tuberculosis and Co-infection Issues In Central Asiamentioning

confidence: 99%

See 1 more Smart Citation

Illicit drugs in Central Asia: What we know, what we don’t know, and what we need to know

Latypov¹,

Grund

El‐Bassel

et al. 2014

International Journal of Drug Policy

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“…[5] Various studies identifying roles of co-morbidities that may have a significant impact on the development of MDR-TB have reported HIV, drug abuse, and diabetes mellitus as the main causes. [6][7][8][9][10] In our study also two patients were treatment naïve and 123 were of group who has received antituberculous treatment for at least 1 month in past.…”

Section: Discussionmentioning

confidence: 99%

Multidrug resistant tuberculosis: Understanding the past for the better future

Prakash¹,

Sahu²,

Khare³

et al. 2016

Int J Med Public Health

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Introduction: Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem. The study was done to evaluate the clinical profile of MDR TB patients and to study the diagnostic parameters in a cohort. Materials and Methods: All MDR-PTB patients admitted in a tertiary level TB institute for initiation of treatment for study period were enrolled. Various clinical parameters such as symptomatology profile, past treatment details, details of diagnosis, and methods of diagnosis were studied retrospectively in these patients. Results: A total of 125 patients were enrolled. An average age was 29.5 ± 12.2 years. The average duration of chest symptoms was 2.4 ± 0.6 years; cough and expectoration were the most common symptoms present in all (100%) the patients. Two patients were treatment naïve, and 123 were retreatment cases, in which, 63 were relapse, 42 were treatment after default, and 18 were failure cases, just prior to being diagnosed as MDR-TB. Forty-three patients have received at least one of the reserve line drugs as part of anti-TB treatment in past. The average courses of treatment taken prior to been labeled as MDR-TB were 3.15 times. Majority of patients (99) had been diagnosed by using molecular-based tests. Conclusion: Use of reserve line drugs is common for treatment of TB, even without being diagnosed as MDR-TB. Both physicians-and patient-related factors responsible for the development of MDR-TB may be prevented by improving understanding of the disease and by early and proper treatment of both drugs susceptible and drug resistant TB.Key words: Antitubercular treatment, molecular tests, multidrug-resistant tuberculosis, reserve live drugs INTRODUCTIONMultidrug-resistant tuberculosis (MDR-TB) is becoming a major public health problem. This form of TB is not only difficult and costly to diagnose, but also tough to treat with increased morbidity and mortality as compared to the drug-susceptible TB. Mycobacterium tuberculosis is one of the important emerging pathogens. Multidrug and poly-drug resistant strains have been increasing around the world.[1] There are 64,000 MDR-TB cases per year in India, out of which only a few are able to reach to the proper healthcare facilities to get treated.[2] The Revised National Tuberculosis Control Program (RNTCP) under Programmatic Management of Drug Resistant Tuberculosis (PMDT) is in the phase of expansion and is making fast progress in terms of expanding the diagnostic facilities, as well as the treatment sites for such patients of MDR TB [2] but still a large proportion of TB patients in their early phase of illness are managed by the private health care sector by either the physician, small private hospitals and nursing homes, or corporate hospitals. AbstractOriginal Article

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“…Migrants are often themselves PWID, 2 and are vulnerable to infectious diseases through high-risk behaviours such as unprotected sex or sharing injection material. 3 In addition, as they often face deportation on disclosing their health status, diagnoses are hidden and treatment is at times interrupted. When they return home, fear of being stigmatised or ignorance of their status can prevent them from seeking health care, placing them at higher risk of transmitting their diseases to their partners or family.…”

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confidence: 99%