Present state of tuberculosis in the Czech Republic and in central European and Baltic countries.
The Central Europe forms a buffer zone between the countries of the European West reporting tuberculosis notification rates lower than 20 per 100,000, the cut-off set between low and high incidence areas, and the Eastern European countries including the republics of the former USSR, Russia and the Baltic States. The Czech Republic holds an intermediate place between these two territories with the total notification rate of tuberculosis cases 18.8, 9.7 bacteriologically verified and 5.7 positive in direct smear per 100,000 in 1996. Data on drug resistance obtained from the WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance were available from the Czech Republic, the only Central European country participating in the Project. The prevalence of resistant cases was here low: 2% primary and 13% acquired, and MDR cases were recorded in 1% of untreated and in 6% of repeatedly treated patients. The first microepidemic of MDR cases comprising 21 individuals was characterized by DNA fingerprinting. This outbreak pointed out the MDR tuberculosis as a new, extremely serious phenomenon in the epidemiology of tuberculosis. Corresponding data from Estonia and Latvia showed incomparably higher values in the drug resistance pattern: from 28 to 34% primary and 46 to 74% acquired resistance. MDR strains were reported in 9 to 14% of untreated and in 19 to 54% of repeatedly treated patients.
Kubín
M
M
National Institute of Public Health, Prague, Czech Republic.
Príkazský
V
V
Havelková
M
M
Svandová
E
E
Levina
K
K
Kurve
A
A
Leimans
J
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001454:Baltic States / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D018153:Czech Republic / Q000453:epidemiology; D016172:DNA Fingerprinting; D018563:Disease Notification / Q000706:statistics & numerical data; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D017678:Sex Distribution; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*