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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International Union Against Tuberculosis and Lung Disease (The Union)
2024-09-01
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| Series: | IJTLD Open |
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| author | 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 |
| author_facet | 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 |
| author_sort | S. Moe |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3bf1d5fd7e69423cbb34b6c4924b53c2 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-3bf1d5fd7e69423cbb34b6c4924b53c22025-01-22T12:16:08ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-09-011939139710.5588/ijtldopen.24.03513Second-line drug-resistant TB and associated risk factors in Karakalpakstan, UzbekistanS. Moe0I. Azamat1S. Allamuratova2M. Oluya3A. Khristusev4M.L. Rekart5K. Mamitova6G. Bidwell7C. Gomez-Restrepo8B. Kalmuratov9Z. Tigay10N. Parpieva11K. Safaev12N. Sitali13D. Gomez14A. Mikhail15A. Sinha16Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;Médecins Sans Frontières (MSF), Nukus, Uzbekistan;MSF, Tashkent, Uzbekistan;Republican Center of Tuberculosis and Pulmonology, Nukus, Uzbekistan;Republican Center of Tuberculosis and Pulmonology, Nukus, Uzbekistan;Republican Specialised Scientific and Practical Medical Center of Tuberculosis and Pulmonology, Tashkent, Uzbekistan;Republican Specialised Scientific and Practical Medical Center of Tuberculosis and Pulmonology, Tashkent, Uzbekistan;MSF, Berlin, Germany;MSF, Amsterdam, Netherlands;MSF, London, UK.MSF, London, UK.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.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000009/art00003epidemiologysecond-line drug-resistant tbgroup-a drug-resistant tbrisk factors |
| spellingShingle | 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 Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan IJTLD Open epidemiology second-line drug-resistant tb group-a drug-resistant tb risk factors |
| title | Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan |
| title_full | Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan |
| title_fullStr | Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan |
| title_full_unstemmed | Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan |
| title_short | Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan |
| title_sort | second line drug resistant tb and associated risk factors in karakalpakstan uzbekistan |
| topic | epidemiology second-line drug-resistant tb group-a drug-resistant tb risk factors |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000009/art00003 |
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