Multidrug-resistant Tuberculosis in Central Asia

Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major threat to TB control, particularly in the former Soviet Union. To determine levels of drug resistance within a directly observed treatment strategy (DOTS) program supported by Médecins Sans Frontières in two regions in Uzbekistan and Turkmenistan, Central Asia, we conducted a cross-sectional survey of smear-positive TB patients in selected districts of Karakalpakstan (Uzbekistan) and Dashoguz (Turkmenistan). High levels of MDR-TB were found in both regions. In Karakalpakstan, 14 (13%) of 106 new patients were infected with MDR-TB; 43 (40%) of 107 previously treated patients were similarly infected. The proportions for Dashoguz were 4% (4/105 patients) and 18% (18/98 patients), respectively. Overall, 27% of patients with positive smear results whose infections were treated through the DOTS program in Karakalpakstan and 11% of similar patients in Dashoguz were infected with multidrug-resistant strains of TB on admission. These results show the need for concerted action by the international community to contain transmission and reduce the effects of MDR-TB

External Quality Control modules and specimen panel composition for six rounds, 2010–2014.

<p>External Quality Control modules and specimen panel composition for six rounds, 2010–2014.</p

Laboratories participating in EQA rounds and modules.

<p>Laboratories participating in EQA rounds and modules.</p

Smear microscopy error rates for microscopy diagnosis by Ziehl-Neelsen, auramine or Kinyoun methods.

<p>Smear microscopy error rates for microscopy diagnosis by Ziehl-Neelsen, auramine or Kinyoun methods.</p