High prevalence of multidrug-resistant tuberculosis in Georgia.
BACKGROUND
Tuberculosis (TB) has emerged as a serious public health problem in the country of Georgia. However, little or no data exist on rates and risk factors for drug-resistant TB, including multidrug-resistant (MDR)-TB, in Georgia.


OBJECTIVE
To assess the prevalence and risk factors for drug-resistant TB.


METHODS
A cross-sectional prospective survey of patients with suspected pulmonary TB was carried out at four sentinel sites (Tbilisi, Zugdidi, Kutaisi, and Batumi) in Georgia between January 1, 2001 and December 31, 2004.


RESULTS
Among 1422 patients with suspected pulmonary TB, 996 (70.0%) were culture positive; 931/996 (93.5%) had drug susceptibility testing performed. Overall, 64.0% of patients (48.3% of new and 85.3% of retreatment cases) had positive cultures for Mycobacterium tuberculosis resistant to >or=1 first-line antituberculosis drugs. The overall prevalence of MDR-TB was 28.1% (10.5% of newly diagnosed patients and 53.1% of retreatment cases). In multivariate analysis, risk factors for MDR-TB included: being a retreatment case (prevalence ratio (PR)=5.28, 95% CI 3.95-7.07), history of injection drug use (PR=1.59, 95% CI 1.21-2.09), and female gender (PR=1.36, 95% CI 1.12-1.65).


CONCLUSIONS
MDR-TB has emerged as a serious public health problem in Georgia and will greatly impact TB control strategies.
National Center for Tuberculosis and Lung Disease, Tbilisi, Republic of Georgia.
Nino
N
Mdivani
Ekaterina
E
Zangaladze
Natalia
N
Volkova
Ekaterina
E
Kourbatova
Thea
T
Jibuti
Natalia
N
Shubladze
Tamar
T
Kutateladze
George
G
Khechinashvili
Carlos
C
del Rio
Archil
A
Salakaia
Henry M
HM
Blumberg
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification*; D015995:Prevalence; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
D000995:Antitubercular Agents