Encouraging outcomes in the first year of a TB control demonstration program

Orel Oblast, Russia

T. Kherosheva, Lorna Thorpe, E. Kiryanova, L. Rybka, V. Gerasichev, M. Shulgina, E. Nemtsova, T. Aptekar, H. Kluge, W. Jakubowiak, M. Grzemska, G. Aquino, C. Wells, B. Kazionny

Research output: Contribution to journalArticle

Abstract

SETTING: Orel, Russia. OBJECTIVE: To evaluate outcomes of tuberculosis (TB) patients treated in the first year of a TB control demonstration project using a revised strategy of directly observed treatment, short-course (DOTS). Standard methods recommended by World Health Organization (WHO) were adapted to include mycobacterial cultures. DESIGN: Retrospective cohort analysis of TB patients diagnosed between October 1999 and September 2000. RESULTS: Among 749 TB patients, 65% had bacteriologic confirmation of pulmonary TB, 31% were diagnosed clinically, and 4% had extra-pulmonary TB. Most (92%) had no previous TB treatment, but 8% were identified as retreatment cases. Of all patients, 41% had new sputum smear-positive TB. No patients were HIV-infected. Multidrug-resistant (MDR) TB levels were 3% among new and 17% among retreatment patients. Among new smear-positive patients, treatment success was 79% (72% cure, 7% completion); remaining outcomes were 8% failure, 3% default, 8% death, and 1% transfer. Success rates for new culture-positive and clinically diagnosed patients were 81% and 91%, respectively. CONCLUSION: Despite historical differences, successful implementation of the revised TB strategy in Russia is possible. Treatment success rates were high, suggesting WHO targets of 85% cure for smear-positive patients is attainable. Obstacles include drug resistance and elevated death rates among smear-positive patients.

Original languageEnglish (US)
Pages (from-to)1045-1051
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume7
Issue number11
StatePublished - Nov 2003

Fingerprint

Russia
Tuberculosis
Retreatment
Pulmonary Tuberculosis
Multidrug-Resistant Tuberculosis
Therapeutics
Sputum
Drug Resistance
Cohort Studies
HIV
Mortality

Keywords

  • Cohort analysis
  • Outcomes
  • Russia
  • Tuberculosis
  • WHO TB control strategy

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Kherosheva, T., Thorpe, L., Kiryanova, E., Rybka, L., Gerasichev, V., Shulgina, M., ... Kazionny, B. (2003). Encouraging outcomes in the first year of a TB control demonstration program: Orel Oblast, Russia. International Journal of Tuberculosis and Lung Disease, 7(11), 1045-1051.

Encouraging outcomes in the first year of a TB control demonstration program : Orel Oblast, Russia. / Kherosheva, T.; Thorpe, Lorna; Kiryanova, E.; Rybka, L.; Gerasichev, V.; Shulgina, M.; Nemtsova, E.; Aptekar, T.; Kluge, H.; Jakubowiak, W.; Grzemska, M.; Aquino, G.; Wells, C.; Kazionny, B.

In: International Journal of Tuberculosis and Lung Disease, Vol. 7, No. 11, 11.2003, p. 1045-1051.

Research output: Contribution to journalArticle

Kherosheva, T, Thorpe, L, Kiryanova, E, Rybka, L, Gerasichev, V, Shulgina, M, Nemtsova, E, Aptekar, T, Kluge, H, Jakubowiak, W, Grzemska, M, Aquino, G, Wells, C & Kazionny, B 2003, 'Encouraging outcomes in the first year of a TB control demonstration program: Orel Oblast, Russia', International Journal of Tuberculosis and Lung Disease, vol. 7, no. 11, pp. 1045-1051.
Kherosheva, T. ; Thorpe, Lorna ; Kiryanova, E. ; Rybka, L. ; Gerasichev, V. ; Shulgina, M. ; Nemtsova, E. ; Aptekar, T. ; Kluge, H. ; Jakubowiak, W. ; Grzemska, M. ; Aquino, G. ; Wells, C. ; Kazionny, B. / Encouraging outcomes in the first year of a TB control demonstration program : Orel Oblast, Russia. In: International Journal of Tuberculosis and Lung Disease. 2003 ; Vol. 7, No. 11. pp. 1045-1051.
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abstract = "SETTING: Orel, Russia. OBJECTIVE: To evaluate outcomes of tuberculosis (TB) patients treated in the first year of a TB control demonstration project using a revised strategy of directly observed treatment, short-course (DOTS). Standard methods recommended by World Health Organization (WHO) were adapted to include mycobacterial cultures. DESIGN: Retrospective cohort analysis of TB patients diagnosed between October 1999 and September 2000. RESULTS: Among 749 TB patients, 65{\%} had bacteriologic confirmation of pulmonary TB, 31{\%} were diagnosed clinically, and 4{\%} had extra-pulmonary TB. Most (92{\%}) had no previous TB treatment, but 8{\%} were identified as retreatment cases. Of all patients, 41{\%} had new sputum smear-positive TB. No patients were HIV-infected. Multidrug-resistant (MDR) TB levels were 3{\%} among new and 17{\%} among retreatment patients. Among new smear-positive patients, treatment success was 79{\%} (72{\%} cure, 7{\%} completion); remaining outcomes were 8{\%} failure, 3{\%} default, 8{\%} death, and 1{\%} transfer. Success rates for new culture-positive and clinically diagnosed patients were 81{\%} and 91{\%}, respectively. CONCLUSION: Despite historical differences, successful implementation of the revised TB strategy in Russia is possible. Treatment success rates were high, suggesting WHO targets of 85{\%} cure for smear-positive patients is attainable. Obstacles include drug resistance and elevated death rates among smear-positive patients.",
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AU - Kherosheva, T.

AU - Thorpe, Lorna

AU - Kiryanova, E.

AU - Rybka, L.

AU - Gerasichev, V.

AU - Shulgina, M.

AU - Nemtsova, E.

AU - Aptekar, T.

AU - Kluge, H.

AU - Jakubowiak, W.

AU - Grzemska, M.

AU - Aquino, G.

AU - Wells, C.

AU - Kazionny, B.

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