Pathophysiology
doi: 10.25005/2074-0581-2018-20-2-3-314-319
TUBERCULOSIS WITH MULTIDRUG-RESISTANT AND EXTENSIVELY DRUG-RESISTANT OF MICOBACTERIUM TUBERCULOSIS IN THE RUSSIAN FEDERATION

A.E. Ergeshov1, V.V. Punga1, L.I. Rusakova1, S.A. Sterlikov1,2, M.A. Yakimova1, Т.V. Izmaylova1

1Central Tuberculosis Research Institute, Moscow, Russian Federation
2Federal Research Institute for Health Organization and Informatics, Moscow, Russian Federation

Objective: To assess the epidemic situation in the Russian Federation on tuberculosis with multidrug-resistant and extensively drug-resistant (MDR, XDR) of the pathogen and the effectiveness of its treatment.

Methods: The information on forms of official statistical observation of the Russian Federation for 2009-2017 was studied. The calculated indicators describing the reservoir of tuberculosis with MDR and XDR of the pathogen are calculated and analyzed the results of treatment.

Results: In 2009-2017 in the civil healthcare, the proportion of tuberculosis patients tested for drug sensitivity increased from 70.9% to 92.6%. The share of tuberculosis patients with MDR increased from 37.3% to 58.4%. The number of patients and prevalence of tuberculosis with MDR stabilized at the level of 24.2-25.9 per 100 thousand of the population. Primary MDR increased from 16.0% to 28.2%. The share of tuberculosis cases with XDR among cases of tuberculosis with MDR is from 11% to 13%. The number of registered cases of tuberculosis with established or presumed resistance, at least to rifampicin, increased from 15,896 in 2011 to 24,367 in 2015, and the frequency of their successful treatment increased from 37.1% to 53.5%. The number of cases registered for treatment of tuberculosis with XDR has increased from 1318 in 2012 to 2614 in 2015, and the frequency of successful treatment has increased from 26.1% to 34.2%. In 2009-2017 an increase in the rate of abacillation of patients with tuberculosis with MDR from 12.9 to 26.2 per 100 average annual bacterial excreta.

Conclusion: In the Russian Federation, there is a stabilization of the epidemic situation in tuberculosis with MDR, but the process of replacing sensitive strains of the pathogen with drug-resistant strains continues. The indicator of the frequency of detection of cases of tuberculosis with MDR of the pathogen in the Russian Federation is 91.5% in relation to the data of WHO experts. The increase in the proportion of successful treatment of patients with MDR and XDR tuberculosis is associated with providing patients with access to anti-tuberculosis drugs of the reserve series, improving the clinical management of patients, introducing new anti-tuberculosis drugs and treatment protocols, and improving the patient's motivation for treatment.

Keywords: Tuberculosis, multiple drug resistance, extensively drug resistance, treatment outcomes.

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References
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Authors' information:

Ergeshov Atadzhan Ergeshovich,
Doctor of Medical Sciences, Full Professor, Director of the Central Tuberculosis Research Institute

Punga Victor Vasilievich,
Doctor of Medical Sciences, Full Professor, Principal Research Officer of the Scientific and Organizational Department, Central Tuberculosis Research Institute

Rusakova Larisa Ivanovna,
Doctor of Medical Sciences, Principal Research Officer, Head of the Scientific and Organizational Department, Central Tuberculosis Research Institute

Sterlikov Sergey Aleksandrovich,
Doctor of Medical Sciences, Deputy Head of the Federal Center for Monitoring the Counteraction to the Spread of Tuberculosis in the Russian Federation, Federal Research Institute for Health Organization and Informatics

Yakimova Marina Arutyunovna,
Candidate of Medical Sciences, Leading Researcher of the Scientific and Organizational Department, Central Tuberculosis Research Institute

Izmaylova Tamara Viktorovna,
Research Officer of the Scientific and Organizational Department, Central Tuberculosis Research Institute

Conflicts of interest: No conflict

Address for correspondence:

Yakimova Marina Arutyunovna

Candidate of Medical Sciences, Leading Researcher of the Scientific and Organizational Department, Central Tuberculosis Research Institute

107564, Russian Federation, Moscow, Yauzskaya Alley, 2

Tel.: (+7) 499 7859079

E-mail: cniitramn@yandex.ru

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