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Treatment outcome of multidrug/extensively drug-resistant tuberculosis in Latvia, 2000–2004

V. Leimane, G. Dravniece, V. Riekstina, I. Sture, S. Kammerer, M.P. Chen, G. Skenders, T.H. Holtz
European Respiratory Journal 2010 36: 584-593; DOI: 10.1183/09031936.00003710
V. Leimane
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G. Dravniece
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V. Riekstina
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I. Sture
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S. Kammerer
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M.P. Chen
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G. Skenders
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T.H. Holtz
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  • For correspondence: tholtz@th.cdc.gov
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Abstract

In the present study, we characterised drug-resistance patterns, compared treatment outcome between extensively and nonextensively drug-resistant tuberculosis (non-XDR-TB) cases, and assessed risk factors for poor outcome in a high-prevalence country that screens all TB patients for first-line anti-TB drug resistance.

We reviewed drug susceptibility test results among all pulmonary TB cases in Latvia diagnosed from 2000–2004, as well as demographic and clinical characteristics, drug-resistance patterns, and treatment outcomes.

During the 5-yr period, 1,027 multidrug-resistant tuberculosis (MDR-TB) cases initiated treatment. Among all cases, the proportion that experienced an outcome of cure or completion increased from 66.2 to 70.2% (p = 0.06 for linear trend). Among the 48 (4.7%) XDR-TB cases, 18 (38%) were cured, four (8%) died, three (6%) defaulted, and treatment failed in 23 (48%). In proportional-hazards analysis, characteristics significantly associated with poor outcome included XDR-TB, being retired, presence of bilateral cavitation, and previous MDR-TB treatment history for those aged ≥55 yrs.

Overall, treatment success among all MDR-TB cases increased over time. Strategies to prevent transmission of XDR-TB and to further improve treatment outcome are crucial for the future of TB control in Latvia.

  • Multidrug-resistant tuberculosis
  • tuberculosis

Footnotes

  • For editorial comments see page 475.

  • This article has supplementary material available from www.erj.esjournals.com

  • Support Statement

    Funding for this study was provided by the Latvian Ministry of Health. A small amount was contributed by the US Agency for International Development to support technical assistance to the project, but they had no role in the conduct of the study.

  • Statement of Interest

    None declared.

  • Received January 7, 2010.
  • Accepted January 15, 2010.
  • ©2010 ERS
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Treatment outcome of multidrug/extensively drug-resistant tuberculosis in Latvia, 2000–2004
V. Leimane, G. Dravniece, V. Riekstina, I. Sture, S. Kammerer, M.P. Chen, G. Skenders, T.H. Holtz
European Respiratory Journal Sep 2010, 36 (3) 584-593; DOI: 10.1183/09031936.00003710

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Treatment outcome of multidrug/extensively drug-resistant tuberculosis in Latvia, 2000–2004
V. Leimane, G. Dravniece, V. Riekstina, I. Sture, S. Kammerer, M.P. Chen, G. Skenders, T.H. Holtz
European Respiratory Journal Sep 2010, 36 (3) 584-593; DOI: 10.1183/09031936.00003710
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