Tuberculosis in key populations in Tajikistan – a snapshot in 2017

Abstract

Introduction: WHO End TB Strategy aims at achieving targets of 90% mortality reduction and 80% reduction in tuberculosis (TB) incidence by 2030, recommending better addressing TB and multidrug-resistant TB (MDR-TB) issues in key populations.
 Aim: The study aimed at having a snapshot of the epidemiological characteristics of the key populations among the new TB patients, registered in Tajikistan during 2017.
 Methodology: A cross-sectional study was conducted, using official TB registration data for all new TB case notification in Tajikistan in 2017.
 Results: The key population included 1,029 (19.8%) patients among all 5,182 new TB cases registered in 2017. The following selected sub-populations were identified: migrant workers – 728 (70.7%), diabetics – 162 (15.7%), HIV-positive – 138 (13.4%), heavy drinkers – 74 (7.2%), drug users – 50 (4.8%), ex-prisoners – 50 (4.8%), and homeless – 9 (0.9%). Among the key population, 307 (29.8%) patients were smear-positive, 145 (14.1%) were drug-sensitive and 116 (11.3%) had MonoDR/MDR-TB. Time to treatment initiation for smear-positive cases was ≤ 5 days for 303 (98.7%) patients. Being a key population was inversely related to gender (female) (OR = 0.25, 95% CI (0.21, 0.29)) and population type (rural) (OR = 0.64, 95% CI (0.55, 0.74)).
 Conclusion: Among the key population the identified overlaps of selected sub-populations would enable more efficiently reaching the certain groups. TB case detection at PHC levels needs to be targeted for improved rates for key population detection. In the key population sub-group of migrant workers’ special migration destinations are recommended to be explored and find out possible associations with drug resistance.

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

“…From an operational perspective, the multiple key population affiliations are important as each group differs in their need for tailored access to clinical, social, and outreach services, thereby increasing the burden on the routine TB/HIV program. Similar cohort profiles with multiple affiliations have been reported by Tajikistan [ 15 ] and Kazakhstan [ 16 ].…”

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

“…3 Among drug-sensitive TB patients, Chi square tests of independence between three migrant categories (internal migrants, external migrants, and non-migrants) and binary treatment outcomes (successful or unsuccessful) yielded a p-value of p < 0.001. 4 Includes poly resistant, rifampicin resistant, multidrug resistant, and extensively drug-resistant forms. Among drug-resistant TB patients, Chi square tests of independence between three migrant categories (internal migrants, external migrants, and non-migrants) and binary treatment outcomes (successful or unsuccessful) yielded a p-value of p = 0.922.…”

“…Therefore, migrants have been recognized as a “key population” requiring special attention in TB prevention and control efforts [ 3 ]. However, achieving this goal remains a challenge, especially in low- and middle-income countries (LMICs) [ 4 , 5 ].…”