Abstract
Abstract Background: Russia has the highest prevalence of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) in the world. This study aims to evaluate the impact of sociodemographic determinants on the effectiveness of therapy in patients with MDR/RR-TB in the Khabarovsk krai region of Russia. Methods: We conducted a retrospective cross-sectional epidemiological study. Using the centralized national database of TB patients, data was collected on 2661 patients diagnosed with TB from 2018 to 2019 in all medical facilities of the region. After applying exclusion criteria, the final sample consisted of 531 patients with determined MDR/RR and with a known chemotherapy outcome. The influence on the therapy outcome of the 13 variables was analyzed using a binary logistic regression. Results: 10 out 13 analyzed variables had no influence on a given therapy’s effectiveness. These variables were sex, age, residence, occupation, substance abuse, presence of disability, circumstance of TB diagnosis, TB localization, HIV coinfection, and history of imprisonment. Previous treatment with Isoniazid and Rifampicin (P = 0.036, AOR 1.987, CI 95% 1.097 to 3.601), cavities absence in the lungs (P = 0.009, AOR 1.720, CI 95% 1.142 to 2.590), and living in a separate apartment (P = 0.023, AOD -1.150, 95% CI -2.223 to -1.027) significantly influenced treatment efficacy. Conclusion: Our findings point to demographic restructuring of the core of MDR/RR-TB carriers in Russia. As a way to resolve this situation, we wish to emphasize shifting the focus from risk groups and facility-based therapy to home-based therapy, as well as focusing on combating the social stigma and further improving HIV care.
Published Version
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