Authors: Goncharova, O. (National Center of Phthisiology, Bishkek, Kyrgyz Republic); Denisiuk, O. (Alliance for Public Health, Kyiv, Ukraine); Zachariah, R. (Médecins Sans Frontières, Brussels Operational Centre, City of Luxembourg, Luxembourg); Davtyan, K. (National Tuberculosis Control Center, Ministry of Health of Armenia, Yerevan, Armenia); Nabirova, D. (Centers for Disease Control and Prevention, Almaty, Kazakhstan); Acosta, C. (World Health Organization Regional Office for Europe, Copenhagen, Denmark; Kadyrov, A. (National Center of Phthisiology, Bishkek, Kyrgyz Republic).
Source: Public Health Action, Volume 7, Number 3, 21 September 2017, pp. 218-223(6)
Setting: Twenty-two first-line, two second-line and one tertiary health facility in Bishkek, the capital of Kyrgyzstan.
Objectives: Among migrants, a marginalized population at risk for acquiring and transmitting tuberculosis (TB), we determined the proportion with TB among all registered TB cases. For those registered at primary-level facilities, we then reported on their demographic and clinical profiles and TB treatment outcomes.
Design: This was a retrospective cohort analysis of 2012–2013 programme data.
Results: Of 2153 TB patients registered in all health facilities, 969 (45%) were migrants, of whom 454 were registered in first-line facilities. Of these, 27% were cross-border migrants, 50% had infectious TB and 12% had drug-resistant TB. Treatment success was 74% for new cases and 44% for retreatment TB (the World Health Organization target is 85%). Failure in new and retreatment TB patients was respectively 8% and 25%. Twenty-six individuals started on a first-line anti-tuberculosis regimen failed due to multidrug-resistant TB. Eight (25%) of 32 individuals on a retreatment TB regimen also failed. Loss to follow-up was 10% for new and 19% for retreatment TB.
Conclusion: Migrants constituted almost half of all TB patients, drug resistance is prevalent and treatment outcomes unsatisfactory. Fostering inter-country collaboration and prioritizing rapid TB diagnostics (Xpert®MTB/RIF) and innovative ways forward for improving treatment outcomes is urgent.
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