BACKGROUND: Tuberculosis (TB) control in Georgia follows the World Health Organization-recommended DOTS strategy, and has reached global TB control targets in the treatment of susceptible TB; however, the management of drug-resistant forms of TB still represents a serious problem. A countrywide drug resistance survey (DRS) found that the prevalence of multidrug-resistant TB (MDR-TB) was respectively 6.8% and 27.4% in new and previously treated TB cases. OBJECTIVE: To determine the prevalence of and risk factors for drug resistance among TB patients to improve case management and control of drug-resistant TB. METHODS: Extensive social, clinical and bacteriological data were collected from patients hospitalized at the National Centre for Tuberculosis and Lung Diseases, Georgia, between 2005 and 2007. RESULTS: Of 605 patients, resistance was observed in 491 (81.2%); MDR-TB was found in 261 (43.1%; 51/222 [23%] new cases and 210/383 [55%] previously treated cases), monoresistant TB in 130 (21.5%), poly-resistant TB in 67 (11.1%) and extensively drug-resistant TB in 33 (5.5%). Female sex, living in the densely populated capital, family TB contact and previous TB treatment were associated with risk of MDR-TB. CONCLUSIONS: These findings confirm the necessity of improving infection control measures and of standardized treatment for drug-resistant TB patients.
BACKGROUND:Tuberculosis (TB) control in Georgia follows the World Health Organization-recommended DOTS strategy, and has reached global TB control targets in the treatment of susceptible TB; however, the management of drug-resistant forms of TB still represents a serious problem. A countrywide drug resistance survey (DRS) found that the prevalence of multidrug-resistant TB (MDR-TB) was respectively 6.8% and 27.4% in new and previously treated TB cases. OBJECTIVE: To determine the prevalence of and risk factors for drug resistance among TB patients to improve case management and control of drug-resistant TB. METHODS: Extensive social, clinical and bacteriological data were collected from patients hospitalized at the National Centre for Tuberculosis and Lung Diseases, Georgia, between 2005 and 2007. RESULTS: Of 605 patients, resistance was observed in 491 (81.2%); MDR-TB was found in 261 (43.1%; 51/222 [23%] new cases and 210/383 [55%] previously treated cases), monoresistant TB in 130 (21.5%), poly-resistant TB in 67 (11.1%) and extensively drug-resistant TB in 33 (5.5%). Female sex, living in the densely populated capital, family TB contact and previous TB treatment were associated with risk of MDR-TB. CONCLUSIONS: These findings confirm the necessity of improving infection control measures and of standardized treatment for drug-resistant TB patients.
Authors: M A Espinal; S J Kim; P G Suarez; K M Kam; A G Khomenko; G B Migliori; J Baéz; A Kochi; C Dye; M C Raviglione Journal: JAMA Date: 2000-05-17 Impact factor: 56.272
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