Alarming levels of multidrug-resistant tuberculosis in Ukraine: results from the first national survey

被引：36

作者：

Pavlenko, E. ^{[1
]}

Barbova, A. ^{[2
]}

Hovhannesyan, A. ^{[3
]}

Tsenilova, Z. ^{[4
]}

Slavuckij, A. ^{[4
]}

Shcherbak-Verlan, B. ^{[4
]}

Zhurilo, A. ^{[5
]}

Vitek, E. ^{[6
]}

Skenders, G. ^{[7
]}

Sela, I. ^{[7
]}

Cabibbe, A. M. ^{[8
]}

Cirillo, D. M. ^{[8
]}

de Colombani, P. ^{[9
]}

Dara, M. ^{[9
]}

Dean, A. ^{[10
]}

Zignol, M. ^{[10
]}

Dadu, A. ^{[9
]}

机构：

[1] Minist Hlth Ukraine, Kiev, Ukraine

[2] Minist Hlth, Cent Reference Lab TB Microbiol Diagnost, Kiev, Ukraine

[3] WHO, Yerevan, Armenia

[4] WHO, Country Off, Kiev, Ukraine

[5] Natl Acad Med Sci Ukraine, Yanovskiis Natl Inst Phthisiol & Pulmonol, Microbiol Lab, Kiev, Ukraine

[6] Off Hlth & Social Transit, US Agcy Int Dev Reg Mission Ukraine Belarus & Rep, Kiev, Ukraine

[7] TB Supranatl Reference Lab, Riga, Latvia

[8] Ist Sci San Raffaele, TB Supranatl Reference Lab, Milan, Italy

[9] WHO, Reg Off Europe, Marmovej 51, DK-2100 Copenhagen, Denmark

[10] WHO, Global TB Programme, Geneva, Switzerland

来源：

INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE | 2018年 / 22卷 / 02期

关键词：

tuberculosis; Ukraine; drug resistance; surveillance; PYRAZINAMIDE RESISTANCE; DRUG-RESISTANCE; RISK-FACTORS; SURVEILLANCE; BYELARUS; COUNTRY; HIV;

D O I：

10.5588/ijtld.17.0254

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE : To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS : A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULTS : The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95% CI 20.7-27.6) and 58.1% (95% CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socioeconomic group. CONCLUSIONS : Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine.

引用

页码：197 / +

页数：10