Tuberculosis report among injection drug users and their partners in Kazakhstan

Hermosilla, Sabrina; El‐Bassel, Nabila; Aifah, Angela; Terlikbayeva, Assel; Zhumadilov, Z.; Berikkhanova, Kulzhan; Darisheva, Meruyert; Gilbert, Louisa; Schluger, Neil W.; Galea, Sandro

doi:10.1016/j.puhe.2015.01.022

Cited by 14 publications

(12 citation statements)

References 51 publications

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“…Strong associations between alcohol dependence and incarceration with smear positivity were observed and both have been previously linked to active TB [ 3 , 6 , 21 , 27 , 28 ]. Exploring TB transmission, due to close contact, confined spaced, and poor ventilation, transmission of TB in prisons is higher than those observed in the general population[ 3 ].…”

Section: Discussionmentioning

confidence: 96%

“…Mycobacterium tuberculosis infection is associated with modifiable factors including incarceration[ 3 ], smoking[ 4 ], alcohol dependence[ 5 ], drug use history[ 6 ], low body mass index (BMI; as both a potential risk factor and symptom of infection)[ 7 ], diabetes [ 7 ], Hepatitis C virus (HCV)[ 8 , 9 ], HIV status [ 10 ], and depression[ 11 ]. While descriptive epidemiological studies have documented the TB burden in Kazakhstan[ 12 ], few have linked these factors to increased infectiousness or identified highly infectious sub-populations.…”

Section: Introductionmentioning

confidence: 99%

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Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan

et al. 2017

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BackgroundSputum smear-positive tuberculosis (TB) patients have a high risk of transmission and are of great epidemiological and infection control significance. Little is known about the smear-positive populations in high TB burden regions, such as Kazakhstan. The objective of this study is to characterize the smear-positive population in Kazakhstan and identify associated modifiable risk factors.MethodsData on incident TB cases’ (identified between April 2012 and March 2014) socio-demographic, risk behavior, and comorbidity characteristics were collected in four regions of Kazakhstan through structured survey and medical record review. We used multivariable logistic regression to determine factors associated with smear positivity.ResultsOf the total sample, 193 (34.3%) of the 562 study participants tested smear-positive. In the final adjusted multivariable logistic regression model, sex (adjusted odds ratio (aOR) = 2.0, 95% CI:1.3–3.1, p < 0.01), incarceration (aOR = 3.6, 95% CI:1.2–11.1, p = 0.03), alcohol dependence (aOR = 2.6, 95% CI:1.2–5.7, p = 0.02), diabetes (aOR = 5.0, 95% CI:2.4–10.7, p < 0.01), and physician access (aOR = 2.7, 95% CI:1.3–5.5p < 0.01) were associated with smear-positivity.ConclusionsIncarceration, alcohol dependence, diabetes, and physician access are associated with smear positivity among incident TB cases in Kazakhstan. To stem the TB epidemic, screening, treatment and prevention policies should address these factors.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan

et al. 2017

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“…Our study represented one of the first analyses of the perceptions and opinions on tuberculosis and TB therapy among people affected by TB in Kyrgyzstan: although extensive research has addressed clinical and medical aspects of TB and DR-TB in Central Asia [ 29 – 36 ], the social aspects and perception of TB and DR-TB in the region and especially in Kyrgyzstan remain unexplored in the scientific literature. Additionally, this study represents one of the first assessments of patient perception/preference of ambulatory versus inpatient care.…”

Section: Discussionmentioning

confidence: 99%

“My Favourite Day Is Sunday”: Community Perceptions of (Drug-Resistant) Tuberculosis and Ambulatory Tuberculosis Care in Kara Suu District, Osh Province, Kyrgyzstan

Burtscher¹,

Bergh

Toktosunov

et al. 2016

PLoS ONE

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ObjectivesKyrgyzstan is one of the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries listed by the WHO. In 2012, Médecins Sans Frontières (MSF) started a drug-resistant tuberculosis (DR-TB) project in Kara Suu District. A qualitative study was undertaken to understand the perception of TB and DR-TB in order to improve the effectiveness and acceptance of the MSF intervention and to support advocacy strategies for an ambulatory model of care.MethodsThis paper reports findings from 63 interviews with patients, caregivers, health care providers and members of communities. Data was analysed using a qualitative content analysis. Validation was ensured by triangulation and a ‘thick’ description of the research context, and by presenting deviant cases.ResultsFindings show that the general population interprets TB as the ‘lungs having a cold’ or as a ‘family disease’ rather than as an infectious illness. From their perspective, individuals facing poor living conditions are more likely to get TB than wealthier people. Vulnerable groups such as drug and alcohol users, homeless persons, ethnic minorities and young women face barriers in accessing health care. As also reported in other publications, TB is highly stigmatised and possible side effects of the long treatment course are seen as unbearable; therefore, people only turn to public health care quite late. Most patients prefer ambulatory treatment because of the much needed emotional support from their social environment, which positively impacts treatment concordance. Health care providers favour inpatient treatment only for a better monitoring of side effects. Health staff increasingly acknowledges the central role they play in supporting DR-TB patients, and the importance of assuming a more empathic attitude.ConclusionsHealth promotion activities should aim at improving knowledge on TB and DR-TB, reducing stigma, and fostering the inclusion of vulnerable populations. Health seeking delays and adherence problems will be countered by further implementation of shortened treatment regimens. An ambulatory model of care is proposed when convenient for the patient; hospitalisation is favoured only when seen as more appropriate for the respective individual.

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“…There is already a large body of empirical evidence showing that history of imprisonment is an important risk factor for TB among those with AIDS [16,17] and those who engage in high-risk behaviours for HIV infection [18]. However, co-infection with HIV and TB among prisoners poses risks not only to the prisoners themselves, but also to prison staff [19,20] and contacts following release.…”

Section: Introductionmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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IntroductionAlmost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death.MethodsA literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence.ResultsVery few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population.ConclusionsPrisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068

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Tuberculosis report among injection drug users and their partners in Kazakhstan

Cited by 14 publications

References 51 publications

Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan

Identifying risk factors associated with smear positivity of pulmonary tuberculosis in Kazakhstan

“My Favourite Day Is Sunday”: Community Perceptions of (Drug-Resistant) Tuberculosis and Ambulatory Tuberculosis Care in Kara Suu District, Osh Province, Kyrgyzstan

Prisoners co‐infected with tuberculosis and HIV: a systematic review

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