Abstract
Introduction: Drug-resistant tuberculosis (TB) is a public health threat in all countries of the former Soviet Union. In Belarus the magnitude of the problem has been unknown, given that no representative, quality-assured data exist.
Objective: To investigate frequencies of 1st and 2nd-line anti-TB drug resistance in Minsk City, and to explore risk factors for multidrug-resistant (MDR) TB.
Methods: Between November 2009 and August 2010 all new and previously treated patients with smear- or culture-positive TB presenting to all TB units in Minsk City were invited to take part in the study. Drug susceptibility testing (DST) for 1st-line drugs was conducted on all isolates; DST for selected 2nd-line drugs was conducted on MDR-TB isolates. External quality assessment of DST was performed at the Stockholm Supranational Reference Laboratory.
Results: 156 new and 67 previously treated TB patients were enrolled in the study. MDR-TB was found in 35.3% (95%CI: 30.8-40.0) of new patients and 76.1% (95%CI: 65.9-84.1) of those previously treated. Extensively drug resistant (XDR) TB was found in 15 of the 106 MDR-TB patients (14.2%; 95%CI: 8.1-22.3). History of previous treatment was found to be an independent predictor of MDR-TB (OR: 5.9; 95%CI: 2.9-12.0) and XDR-TB (OR: 11.1; 95%CI: 2.8-62.9). Patients under 35 years old had a 2.0 times higher odds of MDR-TB than those 35 and older (95%CI: 1.0-4.2). No association was found between MDR-TB and sex.
Conclusions: Very high frequencies of MDR-TB and XDR-TB are documented in Minsk City. These results greatly contribute to the understanding of the burden in urban areas of Belarus and will be complemented by findings of a nationwide survey currently underway.
- © 2011 ERS