TUBERCULOSIS: The New Profile of Drug-Resistant Tuberculosis in Russia: A Global and Local Perspective – Summary of a Joint Workshop

Released: April 8, 2011
Type: Workshop Summary
Topic: Biomedical and Health Research
Activity: Forum on Drug Discovery, Development, and Translation
Board: Board on Health Sciences Policy
Note: Workshop Summaries contain the opinion of the presenters, but do NOT reflect the conclusions of the IOM. Learn more about the differences between Workshop Summaries and Consensus Reports.

Many tuberculosis (TB) experts and health authorities believe that the majority of the world’s drug-resistant TB cases are undiagnosed and untreated. These strains of the airborne disease are resistant to standard antibiotic treatment and present significant challenges in controlling its spread, diagnosing patients quickly and accurately, and using drugs to treat patients effectively. In Russia in recent decades, the rise of drug-resistant TB has been exacerbated by social, political, and economic upheavals. The size of the country presents additional problems in monitoring its occurrence and controlling its spread.
The IOM Forum on Drug Discovery, Development, and Translation, in conjunction with the Russian Academy of Medical Sciences, held a workshop May 26-27, 2010, in Moscow—the second in a series of international meetings designed to gather information from experts on the threat of drug-resistant TB and ways to combat it. Representatives from the Russian public health community shared their experiences in fighting drug-resistant TB, and participants discussed lessons learned, best practices, and new approaches that can be used worldwide to treat and prevent TB.
http://www.iom.edu/Reports/2011/New-Profile-of-Drug-Resistant-Tuberculosis-in-Russia.aspx?utm_medium=etmail&utm_source=Institute%20of%20Medicine&utm_campaign=IOM+Report+Alert+-+REVISED+for+Outlook+07+-+TEST&utm_content=New%20Reports&utm_term=Non-profit

TUBERCULOSIS: Locating people most at-risk for developing tuberculosis in Siberia.

01/20/11




Laboratory in Strezhevoy tests for HIV and MDR-TB.










Recently, PIH-Russia (Partnwers in Health) strengthened its proactive tuberculosis program in Strezhevoy, a town of 45,000 people located about 400 miles north of PIH’s first Russian program in Tomsk City. Isolated by hundreds of miles of tundra, the town is defined by its Siberian culture, the large oil-based production companies that employ much of the city’s workforce, and one of highest incidence rate for HIV and co-infection of tuberculosis HIV and tuberculosis (TB) in that region of Russia. Making matters worse, a disproportionate number of people are developing multidrug-resistant TB (MDR-TB).
Nationwide, Russia reports 85.1 cases of TB for every 100,000 people, compared to only five per 100,000 in the United States. In Tomsk Oblast, where Strezhevoy is located, the number tops 101.5 new cases per 100,000. Additionally, about 13 percent of new TB cases are MDR-TB in Tomsk Oblast. Moreover, curbing the rate of TB in regions like Strezhevoy has been difficult, due in part a high rate of intravenous drug use and its isolation.
In order to reverse these trends, PIH-Russia refined an algorithm used to identify HIV patients who are most at risk of contracting TB. A preventive strike against TB and MDR-TB.
The team used information collected and analyzed over the past decade to create the algorithm. The formula relies on the results of the TB testing, patients’ CD4 count, their exposure to TB, and other factors.
Once identified using the formula, the patients are put on an intense anti-TB drug regimen called Latent TB Infection (LTBI) chemoprophylaxis. They will take the drugs for four months, three times a week, under the direct observation of medical staff. To encourage patients to take care of themselves while on the regimen, they receive food packages during the course of treatment.
If a patient is not able to visit the nearest treatment facility, PIH medical workers will visit the patient in their home as part of the organization’s “Hospital at Home” project.
The goal: prevent people from contracting a disease that is often painful, and for people living with HIV, deadly.
Preventing the spread of TB not only spares the patient, but also reduces the threat of transmitting the disease within the larger community.
http://www.pih.org/news/entry/locating-people-most-at-risk-for-developing-tuberculosis/