Giuseppe
Emeritus
[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]
Eurosurveillance, Volume 19, Issue 11, 20 March 2014 / Research articles
Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011
H E Jenkins <SUP>1</SUP><SUP>,2</SUP>, M Gegia<SUP>3</SUP>, J Furin<SUP>4</SUP>, I Kalandadze<SUP>5</SUP>, U Nanava<SUP>3</SUP>, T Chakhaia<SUP>3</SUP>, T Cohen<SUP>1</SUP><SUP>,6</SUP>
<SUP></SUP>
<SUP>1</SUP>Brigham and Women?s Hospital, Boston, USA - 2 Harvard Medical School, Boston, USA - 3 The National Center for TB and Lung Disease, Tbilisi, Georgia - 4 TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA - 5 David Agmashenebeli University of Georgia, Tbilisi, Georgia - 6 Harvard School of Public Health, Boston, USA
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Citation style for this article: Jenkins HE, Gegia M, Furin J, Kalandadze I, Nanava U, Chakhaia T, Cohen T. Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011. Euro Surveill. 2014;19(11)
ii=20743. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20743
Date of submission: 05 June 2013
_____
In 2011, Georgia, in the Caucasus, reported that 11% of new and 32% of previously treated tuberculosis (TB) cases nationally had multidrug-resistant TB (MDR-TB). To help understand the mechanisms driving these high risks of drug-resistance and plan for targeted interventions, we identified geographical variability in the MDR-TB burden in Georgia and patient-level MDR-TB risk factors. We used routinely collected surveillance data on notified TB cases to estimate the MDR-TB incidence/100,000 people and the percentage of TB cases with MDR-TB for each of 65 districts and regression modelling to identify patient-level MDR-TB risk factors. 1,795 MDR-TB cases were reported (January 2009?June 2011); the nationwide notified MDR-TB incidence was 16.2/100,000 but far higher (837/100,000) in the penitentiary system. We found substantial geographical heterogeneity between districts in the average annual MDR-TB incidence/100,000 (range: 0.0?5.0 among new and 0.0?18.9 among previously treated TB cases) and the percentage of TB cases with MDR-TB (range: 0.0%?33.3% among new and 0.0%?75.0% among previously treated TB cases). Among treatment-na?ve individuals, those in cities had greater MDR-TB risk than those in rural areas (increased odds: 43%; 95% confidence interval: 20%?72%). These results suggest that interventions for interrupting MDR-TB transmission are urgently needed in prisons and urban areas.
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Eurosurveillance, Volume 19, Issue 11, 20 March 2014 / Research articles
Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011
H E Jenkins <SUP>1</SUP><SUP>,2</SUP>, M Gegia<SUP>3</SUP>, J Furin<SUP>4</SUP>, I Kalandadze<SUP>5</SUP>, U Nanava<SUP>3</SUP>, T Chakhaia<SUP>3</SUP>, T Cohen<SUP>1</SUP><SUP>,6</SUP>
<SUP></SUP>
<SUP>1</SUP>Brigham and Women?s Hospital, Boston, USA - 2 Harvard Medical School, Boston, USA - 3 The National Center for TB and Lung Disease, Tbilisi, Georgia - 4 TB Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA - 5 David Agmashenebeli University of Georgia, Tbilisi, Georgia - 6 Harvard School of Public Health, Boston, USA
_____
Citation style for this article: Jenkins HE, Gegia M, Furin J, Kalandadze I, Nanava U, Chakhaia T, Cohen T. Geographical heterogeneity of multidrug-resistant tuberculosis in Georgia, January 2009 to June 2011. Euro Surveill. 2014;19(11)
ii=20743. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20743 Date of submission: 05 June 2013
_____
In 2011, Georgia, in the Caucasus, reported that 11% of new and 32% of previously treated tuberculosis (TB) cases nationally had multidrug-resistant TB (MDR-TB). To help understand the mechanisms driving these high risks of drug-resistance and plan for targeted interventions, we identified geographical variability in the MDR-TB burden in Georgia and patient-level MDR-TB risk factors. We used routinely collected surveillance data on notified TB cases to estimate the MDR-TB incidence/100,000 people and the percentage of TB cases with MDR-TB for each of 65 districts and regression modelling to identify patient-level MDR-TB risk factors. 1,795 MDR-TB cases were reported (January 2009?June 2011); the nationwide notified MDR-TB incidence was 16.2/100,000 but far higher (837/100,000) in the penitentiary system. We found substantial geographical heterogeneity between districts in the average annual MDR-TB incidence/100,000 (range: 0.0?5.0 among new and 0.0?18.9 among previously treated TB cases) and the percentage of TB cases with MDR-TB (range: 0.0%?33.3% among new and 0.0%?75.0% among previously treated TB cases). Among treatment-na?ve individuals, those in cities had greater MDR-TB risk than those in rural areas (increased odds: 43%; 95% confidence interval: 20%?72%). These results suggest that interventions for interrupting MDR-TB transmission are urgently needed in prisons and urban areas.
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