Pregnancy and Birth Outcomes in Patients With Multidrug-Resistant Tuberculosis Treated With Regimens That Include New and Repurposed Drugs.

Among 43 pregnant women receiving multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) treatment with bedaquiline and/or delamanid, 98% had favorable treatment outcomes. Of 31 continued pregnancies, 81% had live births with no reported malformations, and 68% of neonates had normal birth weights. Effective MDR/RR-TB treatment during pregnancy can improve maternal outcomes without harming neonates.

Culture conversion at six months in patients receiving bedaquiline- and delamanid-containing regimens for the treatment of multidrug-resistant tuberculosis.

Rifampicin-resistant/multidrug-resistant (RR/MDR) and extensively drug-resistant (XDR) strains of M. tuberculosis (TB) are serious public health problem in Kazakhstan. In 2012 and 2013, stringent regulatory authorities approved the first new TB drugs in fifty years, bedaquiline and delamanid, offering hope for more effective and less toxic MDR-TB treatment. The endTB Observational Study is a multi-country study that enrolled patients receiving a bedaquiline- or delamanid-containing regimen for RR/MDR-TB between 01 April 2015 and 30 September 2018. In Kazakhstan, 675 patients participated in the study; all had at least 6-months or longer of follow-up after the start of treatment. The present analysis focuses on endTB Observational Study patients living in Kazakhstan who had a positive baseline sputum culture (220 patients) and initiated a bedaquiline- or delamanid-containing regimen between February 1, 2016 and March 31, 2018. Of them, 195 (89%) of patients experienced culture conversion within six months.

Cross-Sectional Study of Chronic Obstructive Pulmonary Disease Prevalence Among Smokers, Ex-Smokers, and Never-Smokers in Almaty, Kazakhstan: Study Protocol.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is significantly underdiagnosed in Kazakhstan, and there is no previously conducted study on COPD prevalence in the country. OBJECTIVE: The purpose of this study is to assess the prevalence of COPD among individuals aged 40 to 59 years based on results of spirometry before and after bronchodilator, presence of structural changes in the lungs (emphysema, inflammatory changes, and thickening of the walls of the large and small airways) detected by computer tomography, and the symptoms of COPD. The study has 3 study groups: smokers of conventional cigarettes, those who had quit smoking 1 to 5 years ago, and those who haven't smoked cigarettes. METHODS: This is an observational study with a cross-sectional design among individuals aged 40 to 59 years in Almaty, Kazakhstan. The sample of 900 individuals of both sexes contains 500 smokers, 200 ex-smokers, and 200 never-smokers. Study measures include spirometry, chest computed tomography, electrocardiography, physical exams, laboratory testing of serum, anthropometry, and 6-minute walk test. Data are collected by computer-assisted personal interviewing with tablets. The questionnaire was designed to explore possible COPD risk factors including history of smoking, current smoking, level of smoking exposure (in pack-years), passive smoking, occupational and environmental hazards, and covariates: age, gender, ethnicity, education, occupation, and self-reported morbidity. COPD Assessment Test (CAT) is used to collect information about COPD symptoms. RESULTS: We have completed the participant recruitment and study procedures. Currently, we are working on data processing and data analysis. The authors anticipate the preliminary results should be available by September 2017. Study results will be published in peer-reviewed scientific journals. CONCLUSIONS: This is the first study in Kazakhstan that assesses prevalence of COPD and its comorbidities in the adult population aged 40 to 59 years. The results of the study will be useful for improving COPD preventive measures, better COPD screening, identification, and registration. Findings of the study will also contribute to global knowledge on the epidemiology of COPD. TRIAL REGISTRATION: ClinicalTrials.gov NCT02926534; https://clinicaltrials.gov/ct2/show/NCT02926534 (Archived by WebCite at http://www.webcitation.org/6rjwGsPOZ).