A K Bentzon1, A Panteleev2, V Mitsura3, E Borodulina4, A Skrahina5, E Denisova6, S Tetradov7, R Podlasin8, V Riekstina9, Z Kancauskiene10, D Paduto11, A Mocroft12, T Trofimova13, R Miller14, F Post15, A Grezesczuk16, J D Lundgren1, M Inglot17, D Podlekareva1, N Bolokadze18, O Kirk1. 1. CHIP (Centre of Excellence for Health, Immunity and Infections), Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 2. Department of HIV/TB, TB Hospital 2, St Petersburg, Russia. 3. Gomel State Medical University, Gomel, Belarus. 4. Department of Phthisiology and Pulmonology, Samara State Medical University of Minzdrav of Russia, Samara, Russia. 5. Republican Research and Practical Clinic for Pulmonology, Minsk, Belarus. 6. Botkin Hospital of Infectious Disease, St Petersburg, Russia. 7. Dr. Victor Babes Hospital, Bucharest, Romania. 8. Wojewodski Szpital Zakanzy/Medical University of Warsaw, Warsaw, Poland. 9. Clinic of TB and Lung Diseases, Riga, Latvia. 10. Clinic for Communicable Diseases and AIDS, Vilnius, Lithuania. 11. Gomel Region Clinic for Hygiene, Svetlogorsk, Belarus. 12. Department of Infection and Population Health, University College London, London, UK. 13. Clinic for Prevention and Control of AIDS, Novgorod, Russia. 14. Mortimer Market Clinic, London, UK. 15. King's College Hospital, London, UK. 16. Medical University Teaching Hospital, Bialystok, Poland. 17. Wroclaw University School of Medicine, Wroclaw, Poland. 18. Infectious Diseases, AIDS and Clinical Immunology Research Clinic, Tbilisi, Georgia.
Abstract
BACKGROUND: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). OBJECTIVES: To verify the differences in TB and HIV services in EE vs. WE. METHODS: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. RESULTS: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. CONCLUSION: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.
BACKGROUND: In a 2013 survey, we reported distinct discrepancies in delivery of tuberculosis (TB) and HIV services in eastern Europe (EE) vs. western Europe (WE). OBJECTIVES: To verify the differences in TB and HIV services in EE vs. WE. METHODS: Twenty-three sites completed a survey in 2018 (EE, 14; WE, nine; 88% response rate). Results were compared across as well as within the two regions. When possible, results were compared with the 2013 survey. RESULTS: Delivery of healthcare was significantly less integrated in EE: provision of TB and HIV services at one site (36% in EE vs. 89% in WE; P = 0.034), and continued TB follow-up in one location (42% vs. 100%; P = 0.007). Although access to TB diagnostics, standard TB and HIV drugs was generally good, fewer sites in EE reported unlimited access to rifabutin/multi-drug-resistant TB (MDR-TB) drugs, HIV integrase inhibitors and opioid substitution therapy (OST). Compared with 2013, routine usage of GeneXpert was more common in EE in 2018 (54% vs. 92%; P = 0.073), as was access to moxifloxacin (46% vs. 91%; P = 0.033), linezolid (31% vs. 64%; P = 0.217), and bedaquiline (0% vs. 25%; P = 0.217). Integration of TB and HIV services (46% vs. 39%; P = 1.000) and provision of OST to patients with opioid dependency (54% vs. 46%; P = 0.695) remained unchanged. CONCLUSION: Delivery of TB and HIV healthcare, including integration of TB and HIV care and access to MDR-TB drugs, still differs between WE and EE, as well as between individual EE sites.
Authors: Christian Kraef; Adrian Bentzon; Alexander Panteleev; Alena Skrahina; Natalie Bolokadze; Simona Tetradov; Regina Podlasin; Igor Karpov; Elena Borodulina; Elena Denisova; Inga Azina; Jens Lundgren; Isik Somuncu Johansen; Amanda Mocroft; Daria Podlekareva; Ole Kirk Journal: BMC Infect Dis Date: 2021-10-06 Impact factor: 3.090
Authors: C Kraef; A Yedilbayev; N Seguy; A Bentzon; D Podlekareva; D M Cirillo; M J van der Werf; O Kirk Journal: Int J Tuberc Lung Dis Date: 2022-09-01 Impact factor: 3.427