Does One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries.

Hdl Handle:
http://hdl.handle.net/10144/17241
Title:
Does One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries.
Authors:
Bonnet, M; Sizaire, V; Kebede, Y; Janin, A; Doshetov, D; Mirzoian, B; Arzumanian, A; Muminov, T; Iona, E; Rigouts, L; Rüsch-Gerdess, S; Varaine, F
Journal:
The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Disease
Abstract:
SETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary.
Affiliation:
Médecins Sans Frontières, Paris, France. maryline.bonnet@geneva.msf.org
Publisher:
International Union Against TB and Lung Disease
Issue Date:
Oct-2005
URI:
http://hdl.handle.net/10144/17241
PubMed ID:
16229227
Additional Links:
http://www.ingentaconnect.com/content/iuatld/ijtld
Language:
en
ISSN:
1027-3719
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorBonnet, M-
dc.contributor.authorSizaire, V-
dc.contributor.authorKebede, Y-
dc.contributor.authorJanin, A-
dc.contributor.authorDoshetov, D-
dc.contributor.authorMirzoian, B-
dc.contributor.authorArzumanian, A-
dc.contributor.authorMuminov, T-
dc.contributor.authorIona, E-
dc.contributor.authorRigouts, L-
dc.contributor.authorRüsch-Gerdess, S-
dc.contributor.authorVaraine, F-
dc.date.accessioned2008-01-31T15:31:38Z-
dc.date.available2008-01-31T15:31:38Z-
dc.date.issued2005-10-
dc.identifier.citationDoes One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries. 2005, 9 (10):1147-54 Int. J. Tuberc. Lung Dis.en
dc.identifier.issn1027-3719-
dc.identifier.pmid16229227-
dc.identifier.urihttp://hdl.handle.net/10144/17241-
dc.description.abstractSETTING: After the collapse of the Soviet Union, countries in the region faced a dramatic increase in tuberculosis cases and the emergence of drug resistance. OBJECTIVE: To discuss the relevance of the DOTS strategy in settings with a high prevalence of drug resistance. DESIGN: Retrospective analysis of one-year treatment outcomes of short-course chemotherapy (SCC) and results of drug susceptibility testing (DST) surveys of six programmes located in the former Soviet Union: Kemerovo prison, Russia; Abkhasia, Georgia; Nagorno-Karabagh, Azerbaijan; Karakalpakstan, Uzbekistan; Dashoguz Velayat, Turkmenistan; and South Kazakhstan Oblast, Kazakhstan. Results are reported for new and previously treated smear-positive patients. RESULTS: Treatment outcomes of 3090 patients and DST results of 1383 patients were collected. Treatment success rates ranged between 87% and 61%, in Nagorno-Karabagh and Kemerovo, respectively, and failure rates between 7% and 23%. Any drug resistance ranged between 66% and 31% in the same programmes. MDR rates ranged between 28% in Karakalpakstan and Kemerovo prison and 4% in Nagorno-Karabagh. CONCLUSION: These results show the limits of SCC in settings with a high prevalence of drug resistance. They demonstrate that adapting treatment according to resistance patterns, access to reliable culture, DST and good quality second-line drugs are necessary.en
dc.language.isoenen
dc.publisherInternational Union Against TB and Lung Disease-
dc.relation.urlhttp://www.ingentaconnect.com/content/iuatld/ijtld-
dc.rightsArchived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.orgen
dc.subject.meshAntitubercular Agentsen
dc.subject.meshConfidence Intervalsen
dc.subject.meshDirectly Observed Therapyen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshOdds Ratioen
dc.subject.meshPrevalenceen
dc.subject.meshRetrospective Studiesen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTuberculosis, Multidrug-Resistanten
dc.subject.meshUSSRen
dc.titleDoes One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries.en
dc.contributor.departmentMédecins Sans Frontières, Paris, France. maryline.bonnet@geneva.msf.orgen
dc.identifier.journalThe International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen

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