Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors

Skrahina, Alena; Hurevich, Henadz; Zalutskaya, Aksana; Sahalchyk, Evgeni; Astrauko, Andrei; Hoffner, Sven; Rusovich, Valiantsin; Dadu, Andrei; Colombani, Pierpaolo de; Dara, Masoud; Gemert, Wayne van; Zignol, Matteo

doi:10.2471/blt.12.104588

Cited by 133 publications

(111 citation statements)

References 24 publications

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“…This confirms that the prevalence of MDR-TB among SN-PTB in the country is as high as that among SP-PTB patients. 3 While certain factors were associated with higher or lower likelihood of having MDR-TB, the prevalence remained consistently high, at around 40-50%, across the different regions and the various socio-demographic and clinical subgroups. Of concern is that all SN-PTB patients with MDR-TB were treated with first-line treatment regimens while awaiting the results of CDST by traditional methods.…”

Section: Discussionmentioning

confidence: 99%

“…ously documented strong associations of MDR-TB with HIV-positive patients 3,15 and unfavourable outcomes, 16,17,5 this missing information is of operational and clinical significance. The reasons for this shortcoming were not known, but the programme has already identified this gap and steps are being taken to increase the uptake of HIV testing and improve its recording in the TB registers.…”

Section: Public Health Action High Mdr-tb Rates In Belarus 246mentioning

confidence: 99%

“…A countrywide survey conducted in 2011 in Belarus revealed a prevalence of MDR-TB of 32% among new and 76% among previously treated TB cases, the highest documented rates worldwide. 3,4 However, these levels were found among sputum smear-positive pulmonary TB (SP-PTB) patients. The levels of MDR-TB among smear-negative pulmonary TB (SN-PTB) patients are unknown, and this group accounts for 63% of all notified new pulmonary TB cases in Belarus.…”

mentioning

confidence: 98%

“…All detected MDR-TB patients have access to second-line anti-tuberculosis treatment as per national guidelines in line with WHO recommendations. 3,4,8 Treatment for MDR-TB is initiated by the board of TB specialists. All diagnostic and treatment services are provided free of charge.…”

Section: Diagnosis Of Smear-negative Pulmonary Tuberculosis Patientsmentioning

confidence: 99%

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High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus

Rusovich¹,

Kumar²,

Skrahina

et al. 2014

public health action

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Eastern Europe is facing an epidemic of multidrug-resistant tuberculosis (MDR-TB). 1,2 Belarus is one of the 27 high MDR-TB burden countries designated by the World Health Organization (WHO). A countrywide survey conducted in 2011 in Belarus revealed a prevalence of MDR-TB of 32% among new and 76% among previously treated TB cases, the highest documented rates worldwide. 3,4 However, these levels were found among sputum smear-positive pulmonary TB (SP-PTB) patients. The levels of MDR-TB among smear-negative pulmonary TB (SN-PTB) patients are unknown, and this group accounts for 63% of all notified new pulmonary TB cases in Belarus. 1 Countries in the WHO European region endorsed the 'Consolidated Action Plan, 2011Plan, -2015, with the aim of detecting 85% of estimated MDR-TB cases and successfully treating at least 75% of these by 2015. 5 Achieving these objectives will not be possible without appropriate management of MDR-TB among SN-PTB.In Belarus, all TB patients have universal access to culture and drug susceptibility testing (CDST). In 2012, at the start of the countrywide roll-out of rapid molecular diagnostics (such as Xpert® MTB/RIF [Cepheid, Inc, Sunnyvale, CA, USA] and line probe assays), national policy prioritised their use for smear-positive TB patients, while SN-PTB patients were investigated using conventional methods, often delaying the diagnosis of MDR-TB by 2-4 months. While awaiting the results, SN-PTB patients were initiated on a first-line drug regimen, which was obviously inadequate if they harboured MDR-TB bacilli. With the increasing availability of rapid molecular diagnostics, the country is currently aiming at universal coverage of all presumptive TB cases with molecular testing. Despite the national policy, SN-PTB patients do not receive the same priority as smear-positive TB patients, as they are traditionally perceived to be less infectious and clinically less severe. Currently, there is no published information from Belarus or similar settings in Eastern Europe on the proportion of SN-PTB patients with MDR-TB. Such information provides the evidence required to decide on and justify the use of rapid molecular diagnostics for all SN-PTB patients.In this countrywide audit in Belarus, we therefore aimed to assess the proportion of MDR-TB among SN-PTB patients registered in 2012 and the associated demographic and clinical factors. METHODS Study designThis was a retrospective cohort study using data routinely recorded in the national electronic TB register. SettingBelarus has a population of 9.5 million, with 72% living in urban areas. There are six administrative regions (Brest, Gomel, Grodno, Mogilev, Minsk and Vitebsk) and 121 districts. The Ministry of Health (MOH) oversees the implementation of TB control activities in the country. The Republican Scientific and Practical Centre for Pulmonology and Tuberculosis (RSPCPT) in Minsk is the central National Tuberculosis Programme (NTP) unit responsible for the development and implementation of TB policies. The Ministry of the Interior has...

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Section: Discussionmentioning

confidence: 99%

Section: Public Health Action High Mdr-tb Rates In Belarus 246mentioning

confidence: 99%

mentioning

confidence: 98%

Section: Diagnosis Of Smear-negative Pulmonary Tuberculosis Patientsmentioning

confidence: 99%

See 2 more Smart Citations

High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus

Rusovich¹,

Kumar²,

Skrahina

et al. 2014

public health action

View full text Add to dashboard Cite

show abstract

“…Several studies have shown that TB contact as strongest determinants of MDR-TB (Kliiman and Attraja, 2009;Balabanova et al, 2012;Lange et al, 2014), but no statistical association was observed between TB contacts and MDR-TB in the present study. The study conducted by Kritski (2003) and Skrahina et al (2013) demonstrated that the smoking habit and alcoholism are strongly associated with MDR-TB. However, our finding infers that the smoking habit and alcoholism have no any co-relation with the development of MDR-TB.…”

Section: Risk Factors Associated With the Development Of Mdr-tbmentioning

confidence: 99%

Risk Factors of Multidrug-Resistant Tuberculosis

Rumende

2017

Int J Appl Sci Biotechnol

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Multidrug-resistant tuberculosis has been increased worldwide which is a severe problem. A case-control study was carried out among 50 MDR-TB cases and 63 drug susceptible controls to identify risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Lumbini Zone. Irregularity in taking medicine (OR=2.36), large family size (OR=2.40), farming as occupation (OR=2.83), history of TB and bovine at home (OR=6.5) were statistically associated with MDR-TB. Most of the MDR-TB cases were males (82%) and individual with the age group 21-30 years (40%) were highly infected with MDR-TB.

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Fused Heterocycles: Synthesis and Antitubercular Activity of Novel 6‐Substituted‐2‐(4‐methyl‐2‐substituted phenylthiazol‐5‐yl)H‐imidazo[1,2‐a]pyridine

Abhale

Deshmukh

Sasane

et al. 2015

Journal of Heterocyclic Chem

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A series of 6‐substituted‐2‐(4‐methyl‐2‐substituted phenylthiazol‐5‐yl)H‐imidazo[1,2‐a]pyridine derivatives 4a, 4b, 4c, 4d, 4e, 4f, 4g, 4h, 4i, 4j, 4k, 4l is described. The antitubercular activity of the synthesized compounds was determined against Mycobacterium smegmatis MC2 155 strain. From the activity result, it was found that the phenyl or 4‐fluorophenyl group at 2 position of thiazole nucleus and bromo substituent at 6 position of imidazo[1,2‐a]pyridine showed good antitubercular activity.

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Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors

Cited by 133 publications

References 24 publications

High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus

High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus

Risk Factors of Multidrug-Resistant Tuberculosis

Fused Heterocycles: Synthesis and Antitubercular Activity of Novel 6‐Substituted‐2‐(4‐methyl‐2‐substituted phenylthiazol‐5‐yl)H‐imidazo[1,2‐a]pyridine

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