Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB.
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.
Kimerling
M E
ME
Department of Medicine, School of Medicine, University of Alabama at Birmingham, USA. kimerlin@uab.edu
Kluge
H
H
Vezhnina
N
N
Iacovazzi
T
T
Demeulenaere
T
T
Portaels
F
F
Matthys
F
F
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
D000995:Antitubercular Agents