Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011.
Euro Surveill
; 19(11)2014 Mar 20.
Article
in En
| MEDLINE
| ID: mdl-24679722
ABSTRACT
In 2011, Georgia, in the Caucasus, reported that 11% of new and 32% of previously treated tuberculosis (TB) cases nationally had multidrug-resistant TB (MDR-TB). To help understand the mechanisms driving these high risks of drug-resistance and plan for targeted interventions, we identified geographical variability in the MDR-TB burden in Georgia and patient-level MDR-TB risk factors. We used routinely collected surveillance data on notified TB cases to estimate the MDR-TB incidence/100,000 people and the percentage of TB cases with MDR-TB for each of 65 districts and regression modelling to identify patient-level MDR-TB risk factors. 1,795 MDR-TB cases were reported (January 2009June 2011); the nationwide notified MDR-TB incidence was 16.2/100,000 but far higher (837/100,000) in the penitentiary system. We found substantial geographical heterogeneity between districts in the average annual MDR-TB incidence/100,000 (range 0.05.0 among new and 0.018.9 among previously treated TB cases) and the percentage of TB cases with MDR-TB (range 0.0%33.3% among new and 0.0%75.0% among previously treated TB cases). Among treatment-naïve individuals, those in cities had greater MDR-TB risk than those in rural areas (increased odds 43%; 95% confidence interval 20%72%). These results suggest that interventions for interrupting MDR-TB transmission are urgently needed in prisons and urban areas.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis, Multidrug-Resistant
/
Geography
Type of study:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Humans
/
Infant
/
Middle aged
/
Newborn
Country/Region as subject:
Europa
Language:
En
Journal:
Euro Surveill
Journal subject:
DOENCAS TRANSMISSIVEIS
Year:
2014
Type:
Article
Affiliation country:
United States