Survival of drug resistant tuberculosis patients in Lithuania: retrospective national cohort study

The research leading to these results has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement FP7-223681.

Methodological aspects of assessing regional publication activity and citations: the case of the RF central federal District Universities

The article focuses on calculations to assess contribution made by University publication activity and citations indicators to the regional integral indicator of publication activity and citations for Voronezh Region, Ivanovo Region, and Ryazan Region. It shows that relative indicators are more significant in calculations of this kind therefore regions with a large number of Universities have no advantage. The article offers a triangular matrix of ratios expressing how much one regional integral indicator of publication activity and citations exceeds the other, which was calculated for the RF Central Federal District regions. Ratios range up to 3.47. It is concluded that the offered triangular matrix of ratios can be useful for arbitrary rankings of items by values of some indicator.Key words: publication activity, citations, regional integral indicator of publication activity and citations, RSCI, RF Central Federal District, a triangular matrix of ratios for arbitrary rankings

Molecular epidemiology and prevalence of mutations conferring rifampicin and isoniazid resistance in Mycobacterium tuberculosis strains from the southern Ukraine

Understanding the molecular epidemiology of tuberculosis (TB) and mutations in genes associated with drug resistance may contribute to the development of appropriate interventions to improve tuberculosis control. A structured questionnaire was used to collect basic epidemiological data from 589 patients with radiologically confirmed TB in the Odessa and Nikolaev regions of the Ukraine in 2003–2004. A non-commercial reverse hybridisation assay and DNA sequencing were used to detect mutations associated with rifampicin and isoniazid resistance. Genotyping was performed using multilocus variable number tandem repeat (VNTR) typing and spoligotyping. Mutations conferring rifampicin and isoniazid resistance were detected in 32.9% and 44.0%, respectively, of 225 Mycobacterium tuberculosis isolates from individual consecutive patients. Mutations in codon 531 and codon 315 of the rpoB and katG genes, respectively, were predominant among drug-resistant isolates. Multidrug (MDR) resistance rates were significantly higher among former prison inmates compared with non-prisoners (54.8% vs. 27.3%; RR 2.01; 95% CI 1.35–2.97) and the prevalence of mutations was higher in Beijing strains sharing the VNTR signature 223325173533424 than in other Beijing strains (71.4% vs. 45.7%; RR 1.74; 95% CI 1.17–2.57), suggesting that this group may be responsible for rapid transmission of MDR TB in the southern Ukraine

The Directly Observed Therapy Short-Course (DOTS) strategy in Samara Oblast, Russian Federation

BACKGROUND: The World Health Organisation (WHO) defines Russia as one of the 22 highest-burden countries for tuberculosis (TB). The WHO Directly Observed Treatment Short Course (DOTS) strategy employing a standardised treatment for 6 months produces the highest cure rates for drug sensitive TB. The Russian TB service traditionally employed individualised treatment. The purpose of this study was to implement a DOTS programme in the civilian and prison sectors of Samara Region of Russia, describe the clinical features and outcomes of recruited patients, determine the proportion of individuals in the cohorts who were infected with drug resistant TB, the degree to which resistance was attributed to the Beijing TB strain family and establish risk factors for drug resistance. METHODS: prospective study RESULTS: 2,099 patients were recruited overall. Treatment outcomes were analysed for patients recruited up to the third quarter of 2003 (n = 920). 75.3% of patients were successfully treated. Unsuccessful outcomes occurred in 7.3% of cases; 3.6% of patients died during treatment, with a significantly higher proportion of smear-positive cases dying compared to smear-negative cases. 14.0% were lost and transferred out. A high proportion of new cases (948 sequential culture-proven TB cases) had tuberculosis that was resistant to first-line drugs; (24.9% isoniazid resistant; 20.3% rifampicin resistant; 17.3% multidrug resistant tuberculosis). Molecular epidemiological analysis demonstrated that half of all isolated strains (50.7%; 375/740) belonged to the Beijing family. Drug resistance including MDR TB was strongly associated with infection with the Beijing strain (for MDR TB, 35.2% in Beijing strains versus 9.5% in non-Beijing strains, OR-5.2. Risk factors for multidrug resistant tuberculosis were: being a prisoner (OR 4.4), having a relapse of tuberculosis (OR 3.5), being infected with a Beijing family TB strain (OR 6.5) and having an unsuccessful outcome from treatment (OR 5.0). CONCLUSION: The implementation of DOTS in Samara, Russia, was feasible and successful. Drug resistant tuberculosis rates in new cases were high and challenge successful outcomes from a conventional DOTS programme alone

Variability in interpretation of chest radiographs among Russian clinicians and implications for screening programmes: observational study.

OBJECTIVE: To determine variability in interpretation of chest radiographs among tuberculosis specialists, radiologists, and respiratory specialists. DESIGN: Observational study. SETTING: Tuberculosis and respiratory disease services, Samara region, Russian Federation. PARTICIPANTS: 101 clinicians involved in the diagnosis and management of pulmonary tuberculosis and respiratory diseases. MAIN OUTCOME MEASURES: Interobserver and intraobserver agreement on the interpretation of 50 digital chest radiographs, using a scale of poor to very good agreement (kappa coefficient: < or = 0.20 poor, 0.21-0.40 fair, 0.41-0.60 moderate, 0.61-0.80 good, and 0.81-1.00 very good). RESULTS: Agreement on the presence or absence of an abnormality was fair only (kappa = 0.380, 95% confidence interval 0.376 to 0.384), moderate for localisation of the abnormality (0.448, 0.444 to 0.452), and fair for a diagnosis of tuberculosis (0.387, 0.382 to 0.391). The highest levels of agreement were among radiologists. Level of experience (years of work in the specialty) influenced agreement on presence of abnormalities and cavities. Levels of intraobserver agreement were fair. CONCLUSIONS: Population screening for tuberculosis in Russia may be less than optimal owing to limited agreement on interpretation of chest radiographs, and may have implications for radiological screening programmes in other countries

Detection of rifampicin and izoniazid resistance in Mycobacterium tuberculosis strains from Samara Region (Central Russia)

Recently high rates of tuberculosis incidence and prevalence are observed in civilian and prisons sectors in Russia. One of the main reasons for high morbidity levels and ineffectiveness of treatment is wide spreading of drug resistant Mycobacterium tuberculosis strains, but accurate and comprehensive information on levels of drug resistance among strains circulating in Central Russia is unavailable. Rifampicin and izoniazid resistance detection in TB isolates from Samara (Central Russia) civilian and prison TB hospitals and dispensaries in 2000–2002 by revealing mutations in rpoB, katG and inhA genes using Macroarray technique. Methods: A total of 342 M. tuberculosis isolates were tested using Macroarray method. It is based on multiplex amplification of rpoB, katG and inhA genes fragments (with three pairs of biotin labeled primers) following by dothybridization with normal and mutant oligonucleotide probes (fragments of rpoB, katG and inhA genes in which mutations occur) immobilized on nylon membrane strips. Mycobacterial DNA was extracted by heating of cell suspensions following by chloroform extraction. Streptavidin-alkaline phosphatase color development system was used for visualization of results

Survival of Civilian and Prisoner Drug-Sensitive, Multi- and Extensive Drug- Resistant Tuberculosis Cohorts Prospectively Followed in Russia

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BRICS' role in global health and the promotion of universal health coverage: the debate continues.

The acronym BRIC was coined by Jim O’Neill, a senior executive at Goldman Sachs, to denote four emerging national economies: Brazil, the Russian Federation, India and China. Although BRICS and other multinational groupings may be useful to policy-makers involved in the development of some foreign policies, it remains unclear if such groupings have a role in the study and development of global health policy. We examine the debate around this issue and focus on BRICS’ potential role in the promotion of universal health coverage – an “umbrella” goal for health in the post-2015 development framework. We do not argue that BRICS has no value as a grouping. The constituent nations do have some things in common: they are all large, populous, diverse countries with many different ethnic, social and – in some cases – religious divisions. They share these characteristics with some other countries, such as Indonesia, Nigeria, Indonesia and Pakistan, that have made less progress toward universal health coverage but may be able to learn from BRICS’ experiences. There is no doubt that, in the promotion of universal health coverage, there is a need for collaboration and shared learning. However, a grouping of countries that may make sense in the coordination of global macroeconomic policy cannot be assumed to be relevant in the development of any global health policy

Modern approaches to pharmacotherapy of community-acquired pneumonia

The study presents current views on the pharmacotherapy of community-acquired pneumonia (CAP). This study also describes in general terms the current pharmacoepidemiological situation of the CAP in Russia and abroad, which can both help medical professionals make an informed choice when choosing a pharmacotherapy, and inspire them to follow-up research and observation