E Pavlenko1, A Barbova2, A Hovhannesyan3, Z Tsenilova4, A Slavuckij4, B Shcherbak-Verlan4, A Zhurilo5, E Vitek6, G Skenders7, I Sela7, A M Cabibbe8, D M Cirillo8, P de Colombani9, M Dara9, A Dean10, M Zignol10, A Dadu9. 1. Ministry of Health of Ukraine, Kiev, Ukraine. 2. Central Reference Laboratory on TB Microbiological Diagnostics of the Ministry of Health, Kiev, Ukraine. 3. World Health Organization (WHO), Yerevan, Armenia. 4. WHO Country Office, Kiev, Ukraine. 5. Microbiology Laboratory, Yanovskii's National Institute of Phthisiology and Pulmonology, National Academy of Medical Science of Ukraine, Kiev, Ukraine. 6. US Agency for International Development Regional Mission for Ukraine, Belarus and Republic of Moldova; Office of Health and Social Transition, Kiev, Ukraine. 7. TB Supranational Reference Laboratory, Riga, Latvia. 8. TB Supranational Reference laboratory San Raffaele Scientific Institute, Milan, Italy. 9. WHO Regional Office for Europe, Copenhagen, Denmark. 10. Global TB Programme, WHO, Geneva, Switzerland.
Abstract
SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE: To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS: A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULTS: The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95%CI 20.7-27.6) and 58.1% (95%CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socio-economic group. CONCLUSIONS: Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine.
SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE: To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS: A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULTS: The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95%CI 20.7-27.6) and 58.1% (95%CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socio-economic group. CONCLUSIONS: Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine.
Authors: Silvia S Chiang; Maria Dolynska; Natasha R Rybak; Andrea T Cruz; Omowunmi Aibana; Yana Sheremeta; Vasyl Petrenko; Andrii Mamotenko; Iana Terleieva; C Robert Horsburgh; Helen E Jenkins Journal: ERJ Open Res Date: 2020-09-14
Authors: Matteo Zignol; Andrea Maurizio Cabibbe; Anna S Dean; Philippe Glaziou; Natavan Alikhanova; Cecilia Ama; Sönke Andres; Anna Barbova; Angeli Borbe-Reyes; Daniel P Chin; Daniela Maria Cirillo; Charlotte Colvin; Andrei Dadu; Andries Dreyer; Michèle Driesen; Christopher Gilpin; Rumina Hasan; Zahra Hasan; Sven Hoffner; Alamdar Hussain; Nazir Ismail; S M Mostofa Kamal; Faisal Masood Khanzada; Michael Kimerling; Thomas Andreas Kohl; Mikael Mansjö; Paolo Miotto; Ya Diul Mukadi; Lindiwe Mvusi; Stefan Niemann; Shaheed V Omar; Leen Rigouts; Marco Schito; Ivita Sela; Mehriban Seyfaddinova; Girts Skenders; Alena Skrahina; Sabira Tahseen; William A Wells; Alexander Zhurilo; Karin Weyer; Katherine Floyd; Mario C Raviglione Journal: Lancet Infect Dis Date: 2018-03-21 Impact factor: 25.071
Authors: Silvia Shinpei Chiang; Yana Sheremeta; Rachel Sophie Padilla; Helen Elizabeth Jenkins; Charles Robert Horsburgh; Vasyl Petrenko; Natasha Renee Rybak Journal: J Epidemiol Glob Health Date: 2019-03
Authors: Anthony D Harries; Yan Lin; Ajay M V Kumar; Srinath Satyanarayana; Kudakwashe C Takarinda; Riitta A Dlodlo; Rony Zachariah; Piero Olliaro Journal: F1000Res Date: 2018-07-05
Authors: Anna S Dean; Matteo Zignol; Andrea Maurizio Cabibbe; Dennis Falzon; Philippe Glaziou; Daniela Maria Cirillo; Claudio U Köser; Lice Y Gonzalez-Angulo; Olga Tosas-Auget; Nazir Ismail; Sabira Tahseen; Maria Cecilia G Ama; Alena Skrahina; Natavan Alikhanova; S M Mostofa Kamal; Katherine Floyd Journal: PLoS Med Date: 2020-01-21 Impact factor: 11.069