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Volume 10, Number 5—May 2004
Research

Multidrug-resistant Tuberculosis in Central Asia

Helen Suzanne Cox*Comments to Author , Juan Daniel Orozco*, Roy Male*, Sabine Ruesch-Gerdes†, Dennis Falzon*, Ian Small*, Darebay Doshetov‡, Yared Kebede§, and Mohammed Aziz¶
Author affiliations: *Médecins Sans Frontières Aral Sea Area Programme, Uzbekistan and Turkmenistan, Tashkent, Uzbekistan; †National Reference Centre for Mycobacteria, Borstel, Germany; ‡Ministry of Health, Nukus, Karakalpakstan, Uzbekistan; §Médecins Sans Frontières, Amsterdam, the Netherlands; ¶World Health Organization, Geneva, Switzerland

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Table 1

Key characteristics of the two regions and countries included in the surveya

Uzbekistan Turkmenistan
Population (6) 25,256,000 4,834,000
GDP per capita (6) U.S.$ 2,333 U.S.$ 5,269
Health expenditure per capita (6) U.S.$ 86 U.S.$ 286
Estimated TB incidence rate (all cases) (7) 92/100,000/y 84/100,000/y
Estimated smear-positive case detection (7) 44% 68%
Karakalpakstan Dashoguz
Population (2001 estimated)b 1,549,761 1,041,372
DOTS implementation 1998 (pilot districts)–2003 (full coverage) 2000 (pilot districts)–2002 (full coverage)
DOTS case notification rate (all cases) 482/100,000/y 213/100,000/y
DOTS case notification rate (smear- positive cases) 192/100,000/y 89/100,000/y
% of smear-positive cases previously treated (2002) 55 53
Success rate (new smear-positive cases registered in 2001) 68% 82%

aGDP, gross domestic product; TB, tuberculosis; DOTS, directly observed treatment strategy.

bSource: ministries of health in each region.

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References
  1. Farmer  PE, Kononets  AS, Borisov  SE, Goldfarb  A, Healing  T, McKee  M. Recrudescent tuberculosis in the Russian Federation. In: Farmer P, Kim J, editors. The global impact of drug-resistant tuberculosis. Boston: Harvard Medical School and the Open Society Institute; 1999.
  2. Espinal  MA, Laszlo  A, Simonsen  L, Boulahbal  F, Kim  SJ, Reniero  A, Global trends in resistance to anti-tuberculosis drugs. N Engl J Med. 2001;344:1294303. DOIPubMedGoogle Scholar
  3. World Health Organization. Anti-tuberculosis drug resistance in the world: the WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance. WHO/TB/97.229. Geneva: The Organization; 1997.
  4. Small  I, van der Meer  J, Upshur  REG. Acting on an environmental disaster: the case of the Aral Sea. Environ Health Perspect. 2001;109:5479. DOIPubMedGoogle Scholar
  5. World Health Organization. Managing tuberculosis at district level. A training course. Geneva: The Organization; 1994.
  6. World Health Organization. Country profiles for Uzbekistan and Turkmenistan. [accessed 18 Nov 2003]. Available from: http://www.who.int/country/uzb/en/
  7. World Health Organization. Global tuberculosis control: surveillance, planning, financing. WHO Report 2003. Geneva: The Organization; 2003. WHO/CDS/TB/2003.316 Reprint. Available from: www.who.int/gtb/publications/globrep/index.html
  8. World Health Organization and the International Union Against Tuberculosis and Lung Disease. Guidelines for the surveillance in drug-resistant tuberculosis. Geneva: The Organization;1997. WHO/TB/96.216.
  9. Kent  PT, Kubica  GP. Public health mycobacteriology. A guide for the level III laboratory. Atlanta: Centers for Disease Control; 1985.
  10. Tsogt  G, Naranabt  N, Buyankhisig  B, Batkhuyag  B, Fujiki  A, Mori  T. The nationwide tuberculosis drug resistance survey in Mongolia, 1999. Int J Tuberc Lung Dis. 2002;6:28994.PubMedGoogle Scholar
  11. Results from DOTS-Plus pilot program. Data presented at the WHO DOTS-Plus Working Group Meeting, Paris, October 2003.
  12. McKee  M, Figueras  J, Chenet  L. Health sector reform in the former soviet republics of central Asia. Int J Health Plann Manage. 1998;13:13147. DOIPubMedGoogle Scholar
  13. The Economist Intelligence Unit. Country Report. Uzbekistan; 2002. [?]
  14. The European Observatory on Health Care Systems. In: Health care in Central Asia. McKee M, Healy J, Falkingham J, editors. Buckingham, UK: Open University Press; 2002. p. 179–93.
  15. Kimerling  ME, Kluge  H, Vezhnina  N, Iacovazzi  T, Demeulenaere  T, Portaels  F, Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB. Int J Tuberc Lung Dis. 1999;3:4513.PubMedGoogle Scholar
  16. United Nations High Commissioner for Refugees. Central Asia on the move. Refugees Magazine 1996 May. Available from: http://www.unhcr.ch/cgi-bin/texis/vtx/
  17. Toungoussova  OS, Caugant  DA, Sandven  P, Mariandyshev  AO, Bjune  G. Drug resistance of Mycobacterium tuberculosis strains isolated from patients with pulmonary tuberculosis in Archangels, Russia. Int J Tuberc Lung Dis. 2002;6:40614.PubMedGoogle Scholar
  18. Lockman  S, Kruuner  A, Binkin  J, Levina  K, Wang  YC, Danilovitsch  M, Clinical outcomes of Estonian patients with multi-drug resistant versus drug-susceptible tuberculosis. Clin Infect Dis. 2001;32:37380. DOIPubMedGoogle Scholar
  19. Espinal  MA, Kim  SJ, Suarez  PG, Kam  KM, Khomenko  AG, Migliori  GB, Standard short-course chemotherapy for drug-resistant tuberculosis, treatment outcomes in 6 countries. JAMA. 2000;283:253745. DOIPubMedGoogle Scholar
  20. Raviglione  MC, Gupta  R, Dye  CM, Espinal  MA. The burden of drug-resistant tuberculosis and mechanisms for its control. Ann N Y Acad Sci. 2001;953:8897. DOIPubMedGoogle Scholar
  21. Farmer  P, Bayona  J, Becerra  J, Furin  J, Henry  C, Hiatt  H, The dilemma of MDR-TB in the global era. Int J Tuberc Lung Dis. 1998;2:86976.PubMedGoogle Scholar

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