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Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB.

1999; National Institutes of Health; Volume: 3; Issue: 5 Linguagem: Inglês

M E Kimerling, Hans Kluge, Natalia Vezhnina, Tiziana Iacovazzi, Tine Demeulenaere, Françoise Portaels, Francine Matthys,

Tuberculosis Research and Epidemiology

Multidrug-resistant tuberculosis (MDR-TB) threatens the progress of global control efforts. Prisons represent a high risk setting for development and transmission of MDR-TB. In a Siberian TB referral prison (Kemerovo region), the treatment failure rate is 35% (June 1996-March 1997), despite implementation of a strict DOTS program and use of the World Health Organization Category 2 re-treatment regimen for all new cases. Among 164 patients (December 1997-March 1998), initial resistance to isoniazid and rifampin is 22.6%. Such a rate is a warning call to reconsider prison control strategies, and importantly, to address the treatment regimens necessary to combat an institutional epidemic of MDR-TB.