Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan

Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan

BACKGROUND: Drug-resistant TB (DR-TB) remains a major public health threat. In 2022, Uzbekistan reported 2,117 cases of DR-TB, with 69% tested for fluoroquinolone resistance. Limited information is available on the prevalence of resistance to bedaquiline, linezolid, and fluoroquinolone, which are ke...

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Main Authors: S. Moe, I. Azamat, S. Allamuratova, M. Oluya, A. Khristusev, M.L. Rekart, K. Mamitova, G. Bidwell, C. Gomez-Restrepo, B. Kalmuratov, Z. Tigay, N. Parpieva, K. Safaev, N. Sitali, D. Gomez, A. Mikhail, A. Sinha
Format: Article
Language:English
Published: International Union Against Tuberculosis and Lung Disease (The Union) 2024-09-01
Series:IJTLD Open
Subjects:
epidemiology
second-line drug-resistant tb
group-a drug-resistant tb
risk factors
Online Access:https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000009/art00003
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Summary:BACKGROUND: Drug-resistant TB (DR-TB) remains a major public health threat. In 2022, Uzbekistan reported 2,117 cases of DR-TB, with 69% tested for fluoroquinolone resistance. Limited information is available on the prevalence of resistance to bedaquiline, linezolid, and fluoroquinolone, which are key components of the all-oral treatment regimen for rifampicin-resistant TB in Uzbekistan. METHODS: A retrospective study was conducted using extensive programmatic data from 2019 to 2023 in Uzbekistan. We assessed second-line drug-resistant TB (SLDR-TB) rates using phenotypic drug susceptibility testing (pDST). Demographic and clinical characteristics associated with SLDR-TB were analysed using multivariable logistic regression models based on the Allen-Cady approach. RESULTS: In total, 2,405 patients with TB who had undergone pDST were included (median age 40 years, 47% female). The overall SLDR-TB resistance rate was 24% (95% CI 22–26). Prevalence of resistance to bedaquiline, linezolid, moxifloxacin, levofloxacin, and amikacin were respectively 3.1%, 0.8%, 15%, 13%, and 12%. Risk factors for SLDR-TB were resistance to rifampicin and/or isoniazid, exposure to clofazimine, retreatment status, contact with drug-susceptible TB case or DR-TB case, and diabetes. CONCLUSIONS: The high prevalence of SLDR-TB is of major concern, emphasising the need for baseline pDST in RR-TB treatment. Identified risk factors can aid early detection of at-risk individuals and inform clinical practice.
ISSN:3005-7590

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