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    Jan 27, 2021
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    Does One Size Fit All? Drug Resistance and Standard Treatments: Results of Six Tuberculosis Programmes in Former Soviet Countries.

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    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
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    Affiliation
    Médecins Sans Frontières, Paris, France. maryline.bonnet@geneva.msf.org
    Issue Date
    2005-10
    
    Metadata
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    Journal
    International Journal of 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.
    Publisher
    International Union Against TB and Lung Disease
    URI
    http://hdl.handle.net/10144/17241
    PubMed ID
    16229227
    Additional Links
    http://www.ingentaconnect.com/content/iuatld/ijtld
    Language
    en
    ISSN
    1027-3719
    Collections
    TB

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