SETTING: Orel, Russia. OBJECTIVE: To evaluate outcomes of tuberculosis (TB) patients treated in the first year of a TB control demonstration project using a revised strategy of directly observed treatment, short-course (DOTS). Standard methods recommended by World Health Organization (WHO) were adapted to include mycobacterial cultures. DESIGN: Retrospective cohort analysis of TB patients diagnosed between October 1999 and September 2000. RESULTS: Among 749 TB patients, 65% had bacteriologic confirmation of pulmonary TB, 31% were diagnosed clinically, and 4% had extra-pulmonary TB. Most (92%) had no previous TB treatment, but 8% were identified as retreatment cases. Of all patients, 41% had new sputum smear-positive TB. No patients were HIV-infected. Multidrug-resistant (MDR) TB levels were 3% among new and 17% among retreatment patients. Among new smear-positive patients, treatment success was 79% (72% cure, 7% completion); remaining outcomes were 8% failure, 3% default, 8% death, and 1% transfer. Success rates for new culture-positive and clinically diagnosed patients were 81% and 91%, respectively. CONCLUSION: Despite historical differences, successful implementation of the revised TB strategy in Russia is possible. Treatment success rates were high, suggesting WHO targets of 85% cure for smear-positive patients is attainable. Obstacles include drug resistance and elevated death rates among smear-positive patients.
SETTING: Orel, Russia. OBJECTIVE: To evaluate outcomes of tuberculosis (TB) patients treated in the first year of a TB control demonstration project using a revised strategy of directly observed treatment, short-course (DOTS). Standard methods recommended by World Health Organization (WHO) were adapted to include mycobacterial cultures. DESIGN: Retrospective cohort analysis of TB patients diagnosed between October 1999 and September 2000. RESULTS: Among 749 TB patients, 65% had bacteriologic confirmation of pulmonary TB, 31% were diagnosed clinically, and 4% had extra-pulmonary TB. Most (92%) had no previous TB treatment, but 8% were identified as retreatment cases. Of all patients, 41% had new sputum smear-positive TB. No patients were HIV-infected. Multidrug-resistant (MDR) TB levels were 3% among new and 17% among retreatment patients. Among new smear-positive patients, treatment success was 79% (72% cure, 7% completion); remaining outcomes were 8% failure, 3% default, 8% death, and 1% transfer. Success rates for new culture-positive and clinically diagnosed patients were 81% and 91%, respectively. CONCLUSION: Despite historical differences, successful implementation of the revised TB strategy in Russia is possible. Treatment success rates were high, suggesting WHO targets of 85% cure for smear-positive patients is attainable. Obstacles include drug resistance and elevated death rates among smear-positive patients.
Authors: Sonya S Shin; Trini A Mathew; Galina V Yanova; Garrett M Fitzmaurice; Viktoriya Livchits; Sergey A Yanov; Aivar K Strelis; Sergey P Mishustin; Nicolai A Bokhan; Charmaine S Lastimoso; Hilary S Connery; Jessica E Hart; Shelly F Greenfield Journal: Cent Eur J Public Health Date: 2010-09 Impact factor: 1.163
Authors: Y Balabanova; M Ruddy; J Hubb; M Yates; N Malomanova; I Fedorin; F Drobniewski Journal: Eur J Clin Microbiol Infect Dis Date: 2005-02 Impact factor: 3.267
Authors: M Ruddy; Y Balabanova; C Graham; I Fedorin; N Malomanova; E Elisarova; S Kuznetznov; G Gusarova; S Zakharova; A Melentyev; E Krukova; V Golishevskaya; V Erokhin; I Dorozhkova; F Drobniewski Journal: Thorax Date: 2005-02 Impact factor: 9.139
Authors: Shelly F Greenfield; Alan Shields; Hilary Smith Connery; Viktoriya Livchits; Sergey A Yanov; Charmaine S Lastimoso; Aivar K Strelis; Sergey P Mishustin; Garrett Fitzmaurice; Trini A Mathew; Sonya Shin Journal: Alcohol Clin Exp Res Date: 2009-11-20 Impact factor: 3.455
Authors: Sonya S Shin; Viktoriya Livchits; Adrianne K Nelson; Charmaine S Lastimoso; Galina V Yanova; Sergey A Yanov; Sergey P Mishustin; Hilary S Connery; Shelly F Greenfield Journal: Harv Rev Psychiatry Date: 2012 Jan-Feb Impact factor: 3.732