title: Prevalence and risk factors for multidrug-resistant tuberculosis in the Republic of Georgia: a population-based study.
abstract: METHODS
  Multidrug-resistant tuberculosis (MDR-TB, defined as resistance to at least isoniazid and rifampicin) has emerged as a serious global public health problem, especially in the former Soviet republics. The extent of the problem in Georgia has been incompletely defined.
  
  
  OBJECTIVE
  To determine the prevalence and risk factors for MDR-TB in Georgia.
  
  
  METHODS
  A population-based study was carried out between July 2005 and May 2006.
  
  
  RESULTS
  Of 1314 patients with acid-fast bacilli smear- and culture-positive pulmonary tuberculosis (TB), 799 (60.8%) were newly diagnosed patients and 515 (39.2%) had been treated previously. Overall, 733 (56%) patients had resistance to at least one anti-tuberculosis drug and 195 (15%) had MDR-TB. Patients who had been treated previously for TB were significantly more likely to have MDR-TB than newly diagnosed patients (141/515 [27.4%] vs. 54/794 [6.8%], OR 5.27, 95%CI 3.75-7.41). In multivariate analysis, previous TB treatment (aOR 5.47, 95%CI 3.87-7.74) and female sex (aOR1.58, 95%CI 1.02-2.32) were independent risk factors for the presence of MDR-TB.
  
  
  CONCLUSIONS
  Drug-resistant TB, including MDR-TB, has emerged as a major public health problem in Georgia. Further TB control efforts need to be implemented to prevent the development of new cases of MDR-TB and to treat existing patients with MDR-TB.
authors.affiliation: National Centre for Tuberculosis and Lung Diseases/National Tuberculosis Programme, Tbilisi, Georgia. nlomtadze@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Lomtadze
authors.forename: R
authors.initials: R
authors.lastname: Aspindzelashvili
authors.forename: M
authors.initials: M
authors.lastname: Janjgava
authors.forename: V
authors.initials: V
authors.lastname: Mirtskhulava
authors.forename: A
authors.initials: A
authors.lastname: Wright
authors.forename: H M
authors.initials: HM
authors.lastname: Blumberg
authors.forename: A
authors.initials: A
authors.lastname: Salakaia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult