Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct 21;4(Suppl 2):S47-53.
doi: 10.5588/pha.14.0041.

Multi- and extensively drug-resistant tuberculosis in Latvia: trends, characteristics and treatment outcomes

L Kuksa  1 , V Riekstina  2 , V Leimane  2 , I Ozere  1 , G Skenders  2 , R Van den Bergh  3 , K Kremer  4 , C D Acosta  4 , A D Harries  5
Affiliations

Multi- and extensively drug-resistant tuberculosis in Latvia: trends, characteristics and treatment outcomes

L Kuksa et al. Public Health Action. .

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 4.3-16.2), have human immunodeficiency virus infection (OR 3.2, 95%CI 1.8-5.7), be illegal drug users (OR 5.7, 95%CI 2.6-11.6) or have had contact with MDR-TB patients (OR 1.9, 95%CI 1.3-2.8). 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.

Keywords: Europe; Latvia; SORT IT; XDR-TB; operational research.

PubMed Disclaimer

Figures

FIGURE
FIGURE
All MDR- and XDR-TB patients registered annually in Latvia, 2000–2010. MDR-TB = multidrug-resistant tuberculosis; XDR-TB = extensively drug-resistant TB.
See this image and copyright information in PMC

References

    1. World Health Organization. Global tuberculosis report, 2013. Geneva, Switzerland: WHO; 2013. WHO/HTM/TB/2013.11.
    1. The World Health Organization/International Union Against Tuberculosis and Lung Disease. Global project on anti-tuberculosis drug resistance surveillance. anti-tuberculosis drug resistance in the world. Geneva, Switzerland: WHO; 1997. WHO/TB/97.229.
    1. Extensively drug-resistant tuberculosis (XDR-TB): recommendations for prevention and control. Wkly Epidemiol Rec. 2006;81:430–432. - PubMed
    1. Leimane V, Dravniece G, Riekstina V et al. Treatment outcome of multidrug/extensively drug-resistant tuberculosis in Latvia, 2000–2004. Eur Respir J. 2010;36:584–593. - PubMed
    1. Government of Latvia. Latvia Statistics. Health care and sport: key indicators. Riga, Latvia: Government of Latvia; 2012. www.csb.gov.lv/en/statistikas-temas/health-care-and-sport-key-indicators... Accessed July 2014.

LinkOut - more resources