title: Low rates of recurrence after successful treatment of multidrug-resistant tuberculosis in Tomsk, Russia.
abstract: METHODS
  Tomsk, Russia, where multidrug-resistant tuberculosis (MDR-TB) is prevalent.
  
  
  OBJECTIVE
  To report rates of recurrence following successful treatment of MDR-TB in a program providing individualized treatment regimens designed according to the current global standard of care.
  
  
  METHODS
  A retrospective cohort study of 408 adults successfully treated for pulmonary MDR-TB from 10 September 2000 to 1 November 2004, and followed for up to 6 years post-treatment. We used Poisson regression with generalized estimating equations to assess whether recurrence rates changed significantly with time.
  
  
  RESULTS
  We analyzed 399 (97.5%) patients with at least one follow-up visit (15 850 person-months of observation [PMO]). Baseline resistance to second-line drugs was common (65.2%); 398 patients (99.7%) were human immunodeficiency virus (HIV) negative. In the first year of post-treatment follow-up, there were six episodes of recurrence (1.4/1000 PMO, 95%CI 0.5-3.0). After the first post-treatment year, there were 21 episodes of recurrence (1.8/1000 PMO, 95%CI 1.1-2.8). The rate did not change significantly with time.
  
  
  CONCLUSIONS
  Individualized regimens designed according to the current global standard of care achieved low rates of MDR-TB recurrence among non-HIV-infected persons treated in a programmatic setting.
authors: Partners In Health Russia, Moscow, Russian Federation.
authors: I Y
authors: IY
authors: Gelmanova
authors: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors: F
authors: F
authors: Ahmad Khan
authors: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA; Partners In Health, Boston, Massachusetts, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: M C
authors: MC
authors: Becerra
authors: Partners In Health Russia, Moscow, Russian Federation.
authors: N A
authors: NA
authors: Zemlyanaya
authors: Tomsk Penitentiary Services, Ministry of Justice, Tomsk, Russian Federation.
authors: I A
authors: IA
authors: Unakova
authors: Tomsk Penitentiary Services, Ministry of Justice, Tomsk, Russian Federation.
authors: Y G
authors: YG
authors: Andreev
authors: Tomsk Oblast Tuberculosis Services, Tomsk, Russian Federation.
authors: V I
authors: VI
authors: Berezina
authors: Tomsk Oblast Tuberculosis Services, Tomsk, Russian Federation.
authors: V E
authors: VE
authors: Pavlova
authors: Partners In Health, Boston, Massachusetts, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors: S
authors: S
authors: Shin
authors: Partners In Health, Boston, Massachusetts, USA.
authors: A B
authors: AB
authors: Yedilbayev
authors: Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russian Federation.
authors: V A
authors: VA
authors: Krasnov
authors: Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA; Partners In Health, Boston, Massachusetts, USA.
authors: S
authors: S
authors: Keshavjee
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D018023:HIV Seronegativity; D006801:Humans; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012426:Russia; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents