Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Setting
2.2.1. General Setting
2.2.2. TB Control
2.2.3. Laboratory Diagnosis
2.3. Study Population
2.4. Data Variables, Data Collection and Sources of Data
2.5. Analysis and Statistics
3. Results
3.1. Numbers of GeneXpert and LPA Instruments Deployed Annually and Regionally
3.2. Numbers of Xpert MTB/RIF and LPA Diagnostic Tests Done Annually
3.3. Performance and Results of Xpert MTB/RIF and LPA Tests
3.4. Numbers with Laboratory-Confirmed MDR/RR-TB and XDR-TB and Numbers Enrolled on Treatment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Region | Population, as of January 2020 | TB Notifications per 100,000 | Number of GeneXpert Instruments | GeneXpert Instruments per 1,000,000 | Number of LPA Instruments |
---|---|---|---|---|---|
Republic of Karakalpakstan | 1,916,400 | 90 | 8 | 4.2 | 2 |
Andijon region | 3,172,300 | 45 | 4 | 1.3 | 0 |
Bukhara region | 1,939,600 | 48 | 4 | 2.1 | 1 |
Jizzakh region | 1,403,200 | 52 | 4 | 2.9 | 0 |
Qashqadaryo region | 3,317,800 | 37 | 4 | 1.2 | 1 |
Nawoiy region | 1,009,200 | 42 | 3 | 3.0 | 1 |
Namangan region | 2,852,600 | 42 | 5 | 1.8 | 1 |
Samarqand region | 3,928,600 | 57 | 4 | 1.0 | 1 |
Surkhondaryo region | 2,667,100 | 36 | 3 | 1.1 | 1 |
Sirdaryo region | 857,100 | 57 | 3 | 3.5 | 0 |
Tashkent region | 2,978,100 | 51 | 4 | 1.3 | 1 |
Farghona region | 3,803,000 | 39 | 4 | 1.1 | 1 |
Khorazm region | 1,884,000 | 45 | 3 | 1.6 | 0 |
Tashkent city | 2,654,100 | 40 | 4 | 1.5 | 3 |
Uzbekistan | 34,383,100 | 47 | 67 * | 1.9 | 13 |
Xpert MTB/RIF Tests | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 |
---|---|---|---|---|---|---|---|---|
Tests performed, n | 5574 | 12,050 | 26,404 | 52,846 | 42,283 | 30,220 | 52,316 | 107,330 |
Tests successfully completed, n (%) | 5005 (90) | 11,116 (92) | 24,828 (94) | 48,776 (92) | 39,776 (94) | 29,271 (97) | 50,849 (97) | 103,144 (96) |
Tests detecting MTB, n (%) a | 1536 (31) | 4032 (36) | 6023 (24) | 9214 (19) | 7388 (19) | 5122 (17) | 9840 (19) | 11,132 (11) |
Rifampicin resistance, n (%) b | 631 (41) | n/a | 2149 (36) | 2765 (30) | 2199 (30) | 1666 (33) | 4043 (41) | 2664 (24) |
Rifampicin sensitive, n (%) b | 880 (57) | n/a | 3628 (60) | 5894 (64) | 4886 (66) | 3397 (66) | 5703 (58) | 7998 (72) |
Rifampicin indeterminate, n (%) b | 25 (2) | n/a | 246 (4) | 555 (6) | 303 (4) | 59 (1) | 94 (1) | 470 (4) |
LPA FL Tests | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 |
---|---|---|---|---|---|---|---|---|
Tests performed, n | 2582 | 2230 | 3871 | 3917 | 6199 | 6556 | 4431 | 6607 |
Tests detecting MTB, n (%) a | 2314 (90) | 2058 (92) | 3444 (89) | 2605 (67) | 4406 (71) | 4421 (67) | 3452 (78) | 5869 (89) |
Rifampicin resistance, n (%) b | 1182 (51) | 892 (43) | 1460 (42) | 1278 (49) | 2078 (47) | 1729 (39) | 1427 (41) | 1976 (34) |
Rifampicin sensitive, n (%) b | 1132 (49) | 1014 (49) | 1984 (58) | 1327 (51) | 2328 (53) | 2692 (61) | 1902 (55) | 3893 (66) |
Isoniazid resistance, n (%) b | 1425 (62) | 1091 (53) | 1736 (50) | 1080 (41) | 2354 (53) | 1230 (28) | 1658 (48) | 2530 (43) |
Isoniazid sensitive, n (%) b | 889 (38) | 814 (40) | 1708 (50) | 1525 (59) | 2052 (47) | 3191 (72) | 1671 (48) | 3339 (57) |
LPA SL Tests | 2016 | 2017 | 2018 | 2019 |
---|---|---|---|---|
Tests performed, n | 1435 | 1058 | 3348 | 6815 |
Tests detecting MTB, n (%) a | 1298 (90) | 789 (75) | 1693 (51) | 3482 (51) |
FQ resistance, n (%) b | 336 (26) | 157 (20) | 587 (35) | 1148 (33) |
FQ sensitive, n (%) b | 962 (74) | 632 (80) | 1106 (65) | 2334 (67) |
Aminoglycoside resistance, n (%) b | 64 (5) | 15 (2) | 598 (35) | 376 (11) |
Aminoglycoside sensitive, n (%) b | 1234 (95) | 774 (98) | 1095 (65) | 1776 (51) |
Patients with TB | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 |
---|---|---|---|---|---|---|---|---|
All types of TB, n | 16,810 | 25,168 | 22,804 | 19,055 | 18,441 | 19,329 | 18,496 | 16,272 |
MDR/RR-TB, n (%) * | 1728 (10.3) | 5751 (22.9) | 4955 (21.7) | 2149 (11.3) | 1956 (10.6) | 2265 (11.7) | 2238 (12.1) | 2060 (12.7) |
XDR-TB, n (%) * | 31 (0.2) | 33 (0.1) | 181 (0.8) | 147 (0.8) | 184 (1.0) | 285 (1.5) | 400 (2.2) | 602 (3.7) |
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Yuldashev, S.; Parpieva, N.; Alimov, S.; Turaev, L.; Safaev, K.; Dumchev, K.; Gadoev, J.; Korotych, O.; Harries, A.D. Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track? Int. J. Environ. Res. Public Health 2021, 18, 4685. https://doi.org/10.3390/ijerph18094685
Yuldashev S, Parpieva N, Alimov S, Turaev L, Safaev K, Dumchev K, Gadoev J, Korotych O, Harries AD. Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track? International Journal of Environmental Research and Public Health. 2021; 18(9):4685. https://doi.org/10.3390/ijerph18094685
Chicago/Turabian StyleYuldashev, Sharofiddin, Nargiza Parpieva, Salikhdjan Alimov, Laziz Turaev, Khasan Safaev, Kostyantyn Dumchev, Jamshid Gadoev, Oleksandr Korotych, and Anthony D. Harries. 2021. "Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?" International Journal of Environmental Research and Public Health 18, no. 9: 4685. https://doi.org/10.3390/ijerph18094685