Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine

Butov Dmytro; Lange Christoph G.; Heyckendorf Jan; Kalmykova Irina; Butova Tatyana; Borovok N.; Novokhatskaya M.; Chesov Dumitru

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BUTOV, Dmytro, LANGE, Christoph G., HEYCKENDORF, Jan, KALMYKOVA, Irina, BUTOVA, Tatyana, BOROVOK, N., NOVOKHATSKAYA, M., CHESOV, Dumitru. Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine. In: International Journal of Tuberculosis and Lung Disease, 2020, nr. 5(24), pp. 485-491. ISSN 1027-3719. DOI: https://doi.org/10.5588/ijtld.19.0508

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International Journal of Tuberculosis and Lung Disease

Numărul 5(24) / 2020 / ISSN 1027-3719 /ISSNe 1815-7920

Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine

DOI:https://doi.org/10.5588/ijtld.19.0508

Pag. 485-491

Butov Dmytro¹, Lange Christoph G.²³⁴, Heyckendorf Jan²³, Kalmykova Irina⁵, Butova Tatyana⁶, Borovok N.⁵, Novokhatskaya M.⁵, Chesov Dumitru²³⁷

¹ National Medical University of Kharkiv,
² Research Center Borstel,
³ German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel-Riems,
⁴ Karolinska Institutet, Stockholm,
⁵ Kharkiv Regional Anti-Tuberculosis Dispensary No 1, Kharkiv,
⁶ V.N.Karazin Kharkiv Natsonal University,
⁷ ”Nicolae Testemițanu” State University of Medicine and Pharmacy

Disponibil în IBN: 19 martie 2021

Rezumat

OBJECTIVE: To document the level of drug resistance in MDR-TB patients and to characterize management capacities for their medical care and MDR-TB treatment outcomes in the Kharkiv region of Ukraine. This area has one of the highest frequencies of MDR-TB worldwide. METHODS: A retrospective observational cohort study was performed on registry data from the regional anti- TB dispensary in Kharkiv. All microbiologically confirmed MDR-TB patients registered in 2014 were included. Diagnostic, treatment and post-treatment follow-up data were analysed. RESULT S: Of 169 patients with MDR-TB, 55.0% had pre-extensively drug-resistant (pre-XDR) or XDR resistant patterns. Rapid molecular diagnosis by GeneXpert and liquid M. tuberculosis cultures were only available for 66.9% and 56.8% of patients, respectively. Phenotypic drug-susceptibility testing (DST) for high priority TB drugs (bedaquiline, linezolid, clofazimine) were not available. DST for later generation fluroquinolones was available only in 53.2% of patients. 50.9% of patients had less than 4 drugs in the treatment regimen proven to be effective by DST. More than 23.1% of patients with MDR-TB failed their treatment and only 45.0% achieved a cure. CONCLUS ION: The high prevalence of MDR-TB and poor MDR-TB treatment outcomes in the Kharkiv region, is associated with substantial shortages in rapid molecular and phenotypic DST, a lack of high priority MDR-TB drugs, poor treatment monitoring and followup capacities.

Cuvinte-cheie
management, MDR-TB, Outcome definitions, TBNET, Ukraine

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<dc:creator>Butov, D.A.</dc:creator>
<dc:creator>Lange, C.</dc:creator>
<dc:creator>Heyckendorf, J.</dc:creator>
<dc:creator>Kalmykova, I.M.</dc:creator>
<dc:creator>Butova, T.S.</dc:creator>
<dc:creator>Borovok, N.</dc:creator>
<dc:creator>Novokhatskaya, M.</dc:creator>
<dc:creator>Chesov, D.I.</dc:creator>
<dc:date>2020-05-01</dc:date>
<dc:description xml:lang='en'><p>OBJECTIVE: To document the level of drug resistance in MDR-TB patients and to characterize management capacities for their medical care and MDR-TB treatment outcomes in the Kharkiv region of Ukraine. This area has one of the highest frequencies of MDR-TB worldwide. METHODS: A retrospective observational cohort study was performed on registry data from the regional anti- TB dispensary in Kharkiv. All microbiologically confirmed MDR-TB patients registered in 2014 were included. Diagnostic, treatment and post-treatment follow-up data were analysed. RESULT S: Of 169 patients with MDR-TB, 55.0% had pre-extensively drug-resistant (pre-XDR) or XDR resistant patterns. Rapid molecular diagnosis by GeneXpert and liquid M. tuberculosis cultures were only available for 66.9% and 56.8% of patients, respectively. Phenotypic drug-susceptibility testing (DST) for high priority TB drugs (bedaquiline, linezolid, clofazimine) were not available. DST for later generation fluroquinolones was available only in 53.2% of patients. 50.9% of patients had less than 4 drugs in the treatment regimen proven to be effective by DST. More than 23.1% of patients with MDR-TB failed their treatment and only 45.0% achieved a cure. CONCLUS ION: The high prevalence of MDR-TB and poor MDR-TB treatment outcomes in the Kharkiv region, is associated with substantial shortages in rapid molecular and phenotypic DST, a lack of high priority MDR-TB drugs, poor treatment monitoring and followup capacities.</p></dc:description>
<dc:identifier>10.5588/ijtld.19.0508</dc:identifier>
<dc:source>International Journal of Tuberculosis and Lung Disease 24 (5) 485-491</dc:source>
<dc:subject>management</dc:subject>
<dc:subject>MDR-TB</dc:subject>
<dc:subject>Outcome definitions</dc:subject>
<dc:subject>TBNET</dc:subject>
<dc:subject>Ukraine</dc:subject>
<dc:title>Multidrug-resistant tuberculosis in the Kharkiv Region, Ukraine</dc:title>
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