title: Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB.
abstract: Multidrug-resistant tuberculosis (MDR-TB) threatens the progress of global control efforts. Prisons represent a high risk setting for development and transmission of MDR-TB. In a Siberian TB referral prison (Kemerovo region), the treatment failure rate is 35% (June 1996-March 1997), despite implementation of a strict DOTS program and use of the World Health Organization Category 2 re-treatment regimen for all new cases. Among 164 patients (December 1997-March 1998), initial resistance to isoniazid and rifampin is 22.6%. Such a rate is a warning call to reconsider prison control strategies, and importantly, to address the treatment regimens necessary to combat an institutional epidemic of MDR-TB.
authors.affiliation: Department of Medicine, School of Medicine, University of Alabama at Birmingham, USA. kimerlin@uab.edu
authors.forename: M E
authors.initials: ME
authors.lastname: Kimerling
authors.forename: H
authors.initials: H
authors.lastname: Kluge
authors.forename: N
authors.initials: N
authors.lastname: Vezhnina
authors.forename: T
authors.initials: T
authors.lastname: Iacovazzi
authors.forename: T
authors.initials: T
authors.lastname: Demeulenaere
authors.forename: F
authors.initials: F
authors.lastname: Portaels
authors.forename: F
authors.initials: F
authors.lastname: Matthys
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D006801:Humans; D008826:Microbial Sensitivity Tests; D011329:Prisoners; D012800:Siberia; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000517:prevention & control; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents