Application of the shorter MDR-TB regimen in high M/XDR-TB burden prison system of Azerbaijan, Abstract

01.12.2016
E Gurbanova 1,2, R Mehdiyev1, K Blondal3, A Altraja2,4

1Ministry of Justice, Main Medical Department, Baku, Azerbaijan;
2University of Tartu,Department of Pulmonary Medicine,Tartu,Estonia;
3Reykjavik Health Care Services, Department of Communicable Disease Prevention and Control, Reykjavik, Iceland;
4Tartu University Hospital, Lung Clinic, Tartu, Estonia.

Source: Abstract Book, 47th World International Conference on Lung Health of the International Union Against Tuberculosis and Lung Disease


Background: In May 2016, the World Health Organization (WHO) recommended the use of standardized shorter multidrug-resistant (MDR) tuberculosis (TB) treatment regimen for patients with rifampicin resistant (RR) TB, including MDR-TB, which is deemed to be less toxic, more effective in terms of patients’ compliance and cost-effective for the TB programmes. In 2015, the proportion of MDR-TB patients in the Penitentiary System (PS) of Azerbaijan was as high as 7% among newly treated and 24% among previously treated TB patients. However, it is unknown, what proportion of patients fulfils the criteria of allocation to the shorter-course treatment.

Objective: To estimate the proportion of RR-TB including MDR-TB patients, who may benefit from the newly recommended regimen in high MDR-TB burden settings of the PS of  Azerbaijan.

Method: We assessed all cases notified in Azerbaijan PS during the period 01.01.2011-31.12.2015 and estimated the proportion of those, who would have met the eligibility criteria for the shorter MDR-TB regimen,  i.e.  new  pulmonary  RR-TB,including MDR-TB cases sensitive to fluoroquinolones, sec- ond-line injectables and  pyrazinamide.

Results: Overall 2463 TB cases including 378 RR-TB (15.3%) and 375 MDR-TB (15.2%) cases were notified in the PS during the study period. Out of RR-TB - 19.6% and out of MDR-TB cases - 18.8% met the eligibility criteria for the shorter MDR-TB regimen (Table).

Conclusions: Our analysis shows that in high MDR- TB burden settings, like PS of Azerbaijan, about one fifth of registered RR-TB, including MDR-TB cases may benefit from the 2016 WHO recommended shorter MDR-TB regimen. However, the proportion  is too small when applied to overall notified TB patients.