33 research outputs found
Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5\u201374.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care
Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance
‘Nature or nurture’: survival rate, oviposition interval, and possible gonotrophic discordance among South East Asian anophelines
Impaired adaptation to repeated restraint and decreased response to cold in urocortin 1 knockout mice
EFFECTIVE WAYS OF SOLVING THE PROBLEM OF MULTUDRUG-RESISTANT TUBERCULOSIS IN THE REPUBLIC OF BELARUS
The article describes the current epidemiological situation of multidrug resistant tuberculosis (MDR TB) in the Republic of Belarus and offers the new approaches to the diagnostics and treatment of MDR TB based on the experience of the Republican TB program and the recommendations of leading international experts. Implementation of new approaches will allow reducing the time necessary for diagnostics and treatment of MDR-TB and to increase its efficiency