Trends, Characteristics and Treatment Outcomes of Patients with Drug-Resistant Tuberculosis in Uzbekistan: 2013–2018

Khasan Safaev, Nargiza Parpieva, Irina Liverko, Sharofiddin Yuldashev, Kostyantyn Dumchev, Jamshid Gadoev, Oleksandr Korotych and Anthony D. Harries
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Khasan Safaev: Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy Str., Tashkent 100086, Uzbekistan
Nargiza Parpieva: Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy Str., Tashkent 100086, Uzbekistan
Irina Liverko: Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy Str., Tashkent 100086, Uzbekistan
Sharofiddin Yuldashev: Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy Str., Tashkent 100086, Uzbekistan
Kostyantyn Dumchev: The Charitable Organization “Ukrainian Institute on Public Health Policy”, 02000 Kyiv, Ukraine
Jamshid Gadoev: World Health Organization Country Office Uzbekistan, 16, M.Tarobiy Str., Tashkent 100100, Uzbekistan
Oleksandr Korotych: World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark
Anthony D. Harries: International Union against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France

IJERPH, 2021, vol. 18, issue 9, 1-15

Abstract: Uzbekistan has a high burden of drug-resistant tuberculosis (TB). Although conventional treatment for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) has been available since 2013, there has been no systematic documentation about its use and effectiveness. We therefore documented at national level the trends, characteristics, and outcomes of patients with drug-resistant TB enrolled for treatment from 2013–2018 and assessed risk factors for unfavorable treatment outcomes (death, failure, loss to follow-up, treatment continuation, change to XDR-TB regimen) in patients treated in Tashkent city from 2016–2017. This was a cohort study using secondary aggregate and individual patient data. Between 2013 and 2018, MDR-TB numbers were stable between 2347 and 2653 per annum, while XDR-TB numbers increased from 33 to 433 per annum. At national level, treatment success (cured and treatment completed) for MDR-TB decreased annually from 63% to 57%, while treatment success for XDR-TB increased annually from 24% to 57%. On multivariable analysis, risk factors for unfavorable outcomes, death, and loss to follow-up in drug-resistant TB patients treated in Tashkent city included XDR-TB, male sex, increasing age, previous TB treatment, alcohol abuse, and associated comorbidities (cardiovascular and liver disease, diabetes, and HIV/AIDS). Reasons for these findings and programmatic implications are discussed.

Keywords: Uzbekistan; Tashkent city; drug-resistant TB; multidrug-resistant TB; extensively drug-resistant TB; unfavorable treatment outcomes; death; loss to follow-up; operational research; SORT IT (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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