Tuberculosis in key populations in Tajikistan - a snapshot in 2017.

Bobojon Pirmahmadzoda,Garry Aslanyan,Karapet Davtyan,Olim Kabirov,Zulfiya Tilloeva,Asliddin Rajabov,Olga Goncharova,Azamdzhon Mirzoev,Seda Aghabekyan

doi:10.3855/jidc.11952

Bobojon Pirmahmadzoda, Garry Aslanyan + Show 7 more

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https://doi.org/10.3855/jidc.11952

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Abstract

WHO End TB Strategy aims at achieving targets of 90% mortality reduction and 80% reduction in tuberculosis (TB) incidence by 2030, recommending better addressing TB and multidrug-resistant TB (MDR-TB) issues in key populations. The study aimed at having a snapshot of the epidemiological characteristics of the key populations among the new TB patients, registered in Tajikistan during 2017. A cross-sectional study was conducted, using official TB registration data for all new TB case notification in Tajikistan in 2017. The key population included 1,029 (19.8%) patients among all 5,182 new TB cases registered in 2017. The following selected sub-populations were identified: migrant workers - 728 (70.7%), diabetics - 162 (15.7%), HIV-positive - 138 (13.4%), heavy drinkers - 74 (7.2%), drug users - 50 (4.8%), ex-prisoners - 50 (4.8%), and homeless - 9 (0.9%). Among the key population, 307 (29.8%) patients were smear-positive, 145 (14.1%) were drug-sensitive and 116 (11.3%) had MonoDR/MDR-TB. Time to treatment initiation for smear-positive cases was ≤ 5 days for 303 (98.7%) patients. Being a key population was inversely related to gender (female) (OR = 0.25, 95% CI (0.21, 0.29)) and population type (rural) (OR = 0.64, 95% CI (0.55, 0.74)). Among the key population the identified overlaps of selected sub-populations would enable more efficiently reaching the certain groups. TB case detection at PHC levels needs to be targeted for improved rates for key population detection. In the key population sub-group of migrant workers' special migration destinations are recommended to be explored and find out possible associations with drug resistance.

Highlights

WHO End TB Strategy aims at achieving targets of 90% mortality reduction and 80% reduction in tuberculosis (TB) incidence by 2030, recommending better addressing TB and multidrug-resistant TB (MDR-TB) issues in key populations
The aim of the study is to provide a snapshot of the TB key populations, by analyzing the epidemiological characteristics of the new TB patients registered in Tajikistan, during the year 2017
In 2002 the country set up a National Tuberculosis Program which follows WHO guidelines for TB [16,17], and implementation of Directly Observed Treatment Strategy (DOTS) Strategy was applied country-wide from 2002 to 2004

Summary

Introduction

WHO End TB Strategy aims at achieving targets of 90% mortality reduction and 80% reduction in tuberculosis (TB) incidence by 2030, recommending better addressing TB and multidrug-resistant TB (MDR-TB) issues in key populations. The prevalence rate of TB has dropped to 1.8-fold in the last twelve years (from 238 cases in 2005 to 126.9 per 100,000 population in 2017) the proportion of multidrug-resistant TB (MDR-TB) among new TB cases increased from 12.5% in 2010 to 20% in 2017 [3]. The proportion of MDR-TB among previously treated cases was 53.6% in 2010 and decreased to 45% in 2017 according to the National Drug Resistance Survey of Tajikistan [4]. The identified sub-populations that are more prone to TB either due to more environmental, biological or behavioral risks or barriers in accessing public services they face. Many of these key populations overlap and Tilloeva et al – TB key populations in Tajikistan

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