@article {Kuksa:2014:2220-8372:S47,
title = "Multi- and extensively drug-resistant tuberculosis in Latvia: trends, characteristics and treatment outcomes",
journal = "Public Health Action",
parent_itemid = "infobike://iuatld/pha",
publishercode ="iuatld",
year = "2014",
volume = "4",
number = "2",
publication date ="2014-10-21T00:00:00",
pages = "S47-S53",
itemtype = "ARTICLE",
issn = "2220-8372",
eissn = "2220-8372",
url = "https://www.ingentaconnect.com/content/iuatld/pha/2014/00000004/a00202s2/art00010",
doi = "doi:10.5588/pha.14.0041",
keyword = "SORT IT, XDR-TB, Europe, operational research, Latvia",
author = "Kuksa, L. and Riekstina, V. and Leimane, V. and Ozere, I. and Skenders, G. and Van den Bergh, R. and Kremer, K. and Acosta, C. D. and Harries, A. D.",
abstract = "
Setting: Drug-resistant tuberculosis (TB) is an important public health problem in Latvia.
Objective: To document trends, characteristics and treatment outcomes of registered patients with multi-drug-resistant (MDR-) and extensively drug-resistant (XDR-) TB in Latvia
from 2000 to 2010.
Design: A retrospective national cohort study.
Results: Of 1779 patients, 1646 (92%) had MDR- and 133 (8%) XDR-TB. Over 11 years, the proportion of XDR-TB among MDR-TB patients increased from 2% to 18%. Compared to MDR-TB patients, those with XDR-TB were
significantly more likely to have failed MDR-TB treatment (OR 8.4, 95%CI 4.316.2), have human immunodeficiency virus infection (OR 3.2, 95%CI 1.85.7), be illegal drug users (OR 5.7, 95%CI 2.611.6) or have had contact with MDR-TB patients (OR 1.9, 95%CI 1.32.8).
Cure rates for XDR-TB were 50%. Compared with MDR-TB patients, those with XDR-TB had a higher risk of treatment failure (29% vs. 8%, respectively, P < 0.001). Unfavourable treatment outcomes were significantly associated with being male; having smear-positive disease; pulmonary cavities;
failure, default or relapse after previous MDR-TB treatment; and a history of incarceration.
Conclusion: More MDR-TB in Latvia is now also XDR-TB. This study identified several risk factors for XDR-TB and, for unfavourable treatment outcomes, highlighting the importance of early
diagnosis and appropriate management of MDR-/XDR-TB.",
}