title: First national survey of anti-tuberculosis drug resistance in Azerbaijan and risk factors analysis.
abstract: METHODS
  Civilian population of the Republic of Azerbaijan.
  
  
  OBJECTIVE
  To determine patterns of anti-tuberculosis drug resistance among new and previously treated pulmonary tuberculosis (TB) cases, and explore their association with socio-demographic and clinical characteristics.
  
  
  METHODS
  National cross-sectional survey conducted in 2012-2013.
  
  
  RESULTS
  Of 789 patients (549 new and 240 previously treated) who met the enrolment criteria, 231 (42%) new and 146 (61%) previously treated patients were resistant to any anti-tuberculosis drug; 72 (13%) new and 66 (28%) previously treated patients had multidrug-resistant TB (MDR-TB). Among MDR-TB cases, 38% of new and 46% of previously treated cases had pre-extensively drug-resistant TB (pre-XDR-TB) or XDR-TB. In previously treated cases, 51% of those who had failed treatment had MDR-TB, which was 15 times higher than in relapse cases (OR 15.2, 95%CI 6-39). The only characteristic significantly associated with MDR-TB was a history of previous treatment (OR 3.1, 95%CI 2.1-4.7); for this group, history of incarceration was an additional risk factor for MDR-TB (OR 2.8, 95%CI 1.1-7.4).
  
  
  CONCLUSIONS
  Azerbaijan remains a high MDR-TB burden country. There is a need to implement countrywide control and innovative measures to accelerate early diagnosis of drug resistance in individual patients, improve treatment adherence and strengthen routine surveillance of drug resistance.
authors.affiliation: Scientific Research Institute of Lung Disease, Baku, Azerbaijan.
authors.forename: N
authors.initials: N
authors.lastname: Alikhanova
authors.affiliation: Scientific Research Institute of Lung Disease, Baku, Azerbaijan.
authors.forename: I
authors.initials: I
authors.lastname: Akhundova
authors.affiliation: Scientific Research Institute of Lung Disease, Baku, Azerbaijan.
authors.forename: M
authors.initials: M
authors.lastname: Seyfaddinova
authors.affiliation: Scientific Research Institute of Lung Disease, Baku, Azerbaijan.
authors.forename: E
authors.initials: E
authors.lastname: Mammadbayov
authors.affiliation: TADR Test & Evaluation Lead Biological Threat Reduction Program Branch of Battelle Memorial Institute, Atlanta, Georgia, USA.
authors.forename: V
authors.initials: V
authors.lastname: Mirtskulava
authors.affiliation: Forsungszentrum Borstel, Borstel, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Rüsch-Gerdes
authors.affiliation: Lung Disease Department, Azerbaijan State Medical University, Baku, Azerbaijan.
authors.forename: R
authors.initials: R
authors.lastname: Bayramov
authors.affiliation: World Health Organization (WHO) Country Office, Baku, Azerbaijan.
authors.forename: J
authors.initials: J
authors.lastname: Suleymanova
authors.affiliation: WHO Regional Office for Europe, Tuberculosis and M/XDR-TB Programme, Division of Communicable Diseases, Health Security & Environment, Copenhagen, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Kremer
authors.affiliation: WHO Regional Office for Europe, Tuberculosis and M/XDR-TB Programme, Division of Communicable Diseases, Health Security & Environment, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Dadu
authors.affiliation: WHO Regional Office for Europe, Tuberculosis and M/XDR-TB Programme, Division of Communicable Diseases, Health Security & Environment, Copenhagen, Denmark.
authors.forename: C D
authors.initials: CD
authors.lastname: Acosta
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.affiliation: WHO Regional Office for Europe, Tuberculosis and M/XDR-TB Programme, Division of Communicable Diseases, Health Security & Environment, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Dara
keywords: Azerbaijan; SORT IT; drug-resistant tuberculosis; operational research; surveillance