Abstract
Tuberculosis (TB) strains with rifampicin-resistance (RR-TB) and multidrug-resistance (RR-TB plus resistance to isoniazid; MDR-TB) are less amenable to treatment than drug-susceptible TB. TB patients in Belarus have the highest risk worldwide for MDR-TB (34% in new; 69% in retreatment cases).
We use surveillance data collected by the national TB programme to generate and discuss key indicators for RR-/MDR-TB response in the country in recent years.
Total TB notifications have declined substantially in Belarus between 2006 and 2014 (6,065 to 4,274). Between 2006 and 2010, detection of RR-/MDR-TB cases increased, then plateaued and declined after 2012. Coverage of testing for RR-/MDR-TB in bacteriologically-confirmed TB cases reached 97% in new and 84% in retreatment. Enrolment on treatment increased between 2010 and 2012, and then declined but still at levels exceeding cases detected. Treatment success improved in successive years but remains low (54% in 2012 cohort) as a result of failure of treatment (22%), death (11%) and interruption (10%).
In recent years Belarus has mounted a substantial response to RR-/MDR-TB. High levels of enrolment may indicate efforts to treat patients diagnosed in previous years but also re-registration of cases within the same year. Treatment success could be improved with enhanced treatment regimens and increased efforts to treat patients earlier and to support adherence.
- Copyright ©the authors 2016