title: Multidrug-resistant tuberculosis in central Asia.
abstract: Multidrug-resistant tuberculosis (MDR-TB) has emerged as a major threat to TB control, particularly in the former Soviet Union. To determine levels of drug resistance within a directly observed treatment strategy (DOTS) program supported by Médecins Sans Frontières in two regions in Uzbekistan and Turkmenistan, Central Asia, we conducted a cross-sectional survey of smear-positive TB patients in selected districts of Karakalpakstan (Uzbekistan) and Dashoguz (Turkmenistan). High levels of MDR-TB were found in both regions. In Karakalpakstan, 14 (13%) of 106 new patients were infected with MDR-TB; 43 (40%) of 107 previously treated patients were similarly infected. The proportions for Dashoguz were 4% (4/105 patients) and 18% (18/98 patients), respectively. Overall, 27% of patients with positive smear results whose infections were treated through the DOTS program in Karakalpakstan and 11% of similar patients in Dashoguz were infected with multidrug-resistant strains of TB on admission. These results show the need for concerted action by the international community to contain transmission and reduce the effects of MDR-TB.
authors.affiliation: Médecins Sans Frontières Aral Sea Area Programme, Uzbekistan and Turkmenistan, Tashkent, Uzbekistan. hom@msfh-tashkent.uz
authors.forename: Helen Suzanne
authors.initials: HS
authors.lastname: Cox
authors.forename: Juan Daniel
authors.initials: JD
authors.lastname: Orozco
authors.forename: Roy
authors.initials: R
authors.lastname: Male
authors.forename: Sabine
authors.initials: S
authors.lastname: Ruesch-Gerdes
authors.forename: Dennis
authors.initials: D
authors.lastname: Falzon
authors.forename: Ian
authors.initials: I
authors.lastname: Small
authors.forename: Darebay
authors.initials: D
authors.lastname: Doshetov
authors.forename: Yared
authors.initials: Y
authors.lastname: Kebede
authors.forename: Mohammed
authors.initials: M
authors.lastname: Aziz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000995:Antitubercular Agents / Q000494:pharmacology; D002648:Child; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology; D014423:Turkmenistan / Q000453:epidemiology; D014610:Uzbekistan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents