Alarming levels of multidrug-resistant tuberculosis in Ukraine: Results from the first national survey

E Pavlenko, A Barbova, A Hovhannesyan, Z Tsenilova, A Slavuckij, B Shcherbak-Verlan, A Zhurilo, E Vitek, G Skenders, I Sela, AM Cabibbe, DM Cirillo, P De Colombani, M Dara, A Dean, M Zignol, A Dadu

Research output: Contribution to journalArticle

Abstract

SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE : To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS : A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULT S : The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95%CI 20.7-27.6) and 58.1% (95%CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socioeconomic group. CONCLUS IONS : Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine. © 2018 The Union.
Original languageEnglish
Pages (from-to)197-205
Number of pages9
JournalInternational Journal of Tuberculosis and Lung Disease
Volume22
Issue number2
DOIs
Publication statusPublished - 2018

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Ukraine
Multidrug-Resistant Tuberculosis
Rifampin
Sputum
Pyrazinamide
Fluoroquinolones
Drug Resistance
Pharmaceutical Preparations
Surveys and Questionnaires
HIV
Lung
Injections
Genes

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Pavlenko, E., Barbova, A., Hovhannesyan, A., Tsenilova, Z., Slavuckij, A., Shcherbak-Verlan, B., ... Dadu, A. (2018). Alarming levels of multidrug-resistant tuberculosis in Ukraine: Results from the first national survey. International Journal of Tuberculosis and Lung Disease, 22(2), 197-205. https://doi.org/10.5588/ijtld.17.0254

Alarming levels of multidrug-resistant tuberculosis in Ukraine: Results from the first national survey. / Pavlenko, E; Barbova, A; Hovhannesyan, A; Tsenilova, Z; Slavuckij, A; Shcherbak-Verlan, B; Zhurilo, A; Vitek, E; Skenders, G; Sela, I; Cabibbe, AM; Cirillo, DM; De Colombani, P; Dara, M; Dean, A; Zignol, M; Dadu, A.

In: International Journal of Tuberculosis and Lung Disease, Vol. 22, No. 2, 2018, p. 197-205.

Research output: Contribution to journalArticle

Pavlenko, E, Barbova, A, Hovhannesyan, A, Tsenilova, Z, Slavuckij, A, Shcherbak-Verlan, B, Zhurilo, A, Vitek, E, Skenders, G, Sela, I, Cabibbe, AM, Cirillo, DM, De Colombani, P, Dara, M, Dean, A, Zignol, M & Dadu, A 2018, 'Alarming levels of multidrug-resistant tuberculosis in Ukraine: Results from the first national survey', International Journal of Tuberculosis and Lung Disease, vol. 22, no. 2, pp. 197-205. https://doi.org/10.5588/ijtld.17.0254
Pavlenko, E ; Barbova, A ; Hovhannesyan, A ; Tsenilova, Z ; Slavuckij, A ; Shcherbak-Verlan, B ; Zhurilo, A ; Vitek, E ; Skenders, G ; Sela, I ; Cabibbe, AM ; Cirillo, DM ; De Colombani, P ; Dara, M ; Dean, A ; Zignol, M ; Dadu, A. / Alarming levels of multidrug-resistant tuberculosis in Ukraine: Results from the first national survey. In: International Journal of Tuberculosis and Lung Disease. 2018 ; Vol. 22, No. 2. pp. 197-205.
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abstract = "SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE : To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS : A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULT S : The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1{\%} (95{\%}CI 20.7-27.6) and 58.1{\%} (95{\%}CI 52.1-64.1). More than one third (38.0{\%}) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socioeconomic group. CONCLUS IONS : Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine. {\circledC} 2018 The Union.",
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AU - Hovhannesyan, A

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AU - Slavuckij, A

AU - Shcherbak-Verlan, B

AU - Zhurilo, A

AU - Vitek, E

AU - Skenders, G

AU - Sela, I

AU - Cabibbe, AM

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N2 - SETTING: The true prevalence of multidrug-resistant tuberculosis (MDR-TB) in Ukraine is not known. Available data are a decade old and limited to only one province. OBJECTIVE : To determine the prevalence of MDR-TB among new and previously treated TB cases in Ukraine and explore the risk factors associated with drug resistance. METHODS : A total of 1550 sputum smear-positive pulmonary TB patients were recruited from 40 clusters throughout Ukraine. Sputum specimens were examined using culture, drug susceptibility testing and pncA gene sequencing. RESULT S : The proportion of MDR-TB among new and previously treated TB cases was respectively 24.1% (95%CI 20.7-27.6) and 58.1% (95%CI 52.1-64.1). More than one third (38.0%) of MDR-TB or rifampicin (RMP) resistant cases showed resistance to either a fluoroquinolone (FQ) or a second-line injectable agent or both. Resistance to pyrazinamide and FQs was low in patients with RMP-susceptible TB. Among new TB cases, the odds of MDR-TB were higher among patients who were younger, female and living in south-eastern provinces, as well as among human immunodeficiency virus-positive patients who belonged to a low socioeconomic group. CONCLUS IONS : Our study showed that the burden of MDR-TB in Ukraine was much greater than previously assumed. Urgent actions are needed to prevent further spread of drug-resistant TB in Ukraine. © 2018 The Union.

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