Multi- and extensively drug-resistant tuberculosis in Latvia: Trends, characteristics and treatment outcomes

Liga Kuksa, V. Riekstina, V. Leimane, I. Ozere, G. Skenders, R. Vandenbergh, K. Kremer, C. D. Acosta, A. D. Harries

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
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Abstract

Setting: Drug-resistant tuberculosis (TB) is an important public health problem in Latvia. Objective: To document trends, characteristics and treatment outcomes of registered patients with multidrug- resistant (MDR-) and extensively drug-resistant (XDR-) TB in Latvia from 2000 to 2010. Design: A retrospective national cohort study. Results: Of 1779 patients, 1646 (92%) had MDR- and 133 (8%) XDR-TB. Over 11 years, the proportion of XDR-TB among MDR-TB patients increased from 2% to 18%. Compared to MDR-TB patients, those with XDR-TB were significantly more likely to have failed MDR-TB treatment (OR 8.4, 95%CI 4.3–16.2), have human immunodeficiency virus infection (OR 3.2, 95%CI 1.8–5.7), be illegal drug users (OR 5.7, 95%CI 2.6–11.6) or have had contact with MDR-TB patients (OR 1.9, 95%CI 1.3– 2.8). Cure rates for XDR-TB were 50%. Compared with MDR-TB patients, those with XDR-TB had a higher risk of treatment failure (29% vs. 8%, respectively, P < 0.001). Unfavourable treatment outcomes were significantly associated with being male; having smear-positive disease; pulmonary cavities; failure, default or relapse after previous MDR-TB treatment; and a history of incarceration. Conclusion: More MDR-TB in Latvia is now also XDR-TB. This study identified several risk factors for XDR-TB and, for unfavourable treatment outcomes, highlighting the importance of early diagnosis and appropriate management of MDR-/XDR-TB.

Original languageEnglish
Pages (from-to)S47-S53
JournalPublic Health Action
Volume4
DOIs
Publication statusPublished - 21 Oct 2014

Keywords

  • Europe
  • Latvia
  • Operational research
  • SORT IT
  • XDR-TB

Field of Science

  • 3.2 Clinical medicine
  • 3.3 Health sciences

Publication Type

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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