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Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?

Author

Listed:
  • Sharofiddin Yuldashev

    (Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy str, Tashkent 100086, Uzbekistan)

  • Nargiza Parpieva

    (Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy str, Tashkent 100086, Uzbekistan)

  • Salikhdjan Alimov

    (Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy str, Tashkent 100086, Uzbekistan)

  • Laziz Turaev

    (Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy str, Tashkent 100086, Uzbekistan)

  • Khasan Safaev

    (Republican Specialized Scientific Practical Medical Centre of Phthisiology and Pulmonology under Ministry of Health of the Republic of Uzbekistan, 1 Majlisiy str, Tashkent 100086, Uzbekistan)

  • Kostyantyn Dumchev

    (The Charitable Organization “Ukrainian Institute of Public Health Policy”, Biloruska St, 5, 02000 Kyiv, Ukraine)

  • Jamshid Gadoev

    (World Health Organization Country Office to Uzbekistan, M. Tarobiy St, 16, Tashkent 100100, Uzbekistan)

  • Oleksandr Korotych

    (World Health Organization Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen, Denmark)

  • Anthony D. Harries

    (International Union against Tuberculosis and Lung Disease, 68 Boulevard Saint Michel, 75006 Paris, France
    London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK)

Abstract

Uzbekistan has a large burden of drug-resistant tuberculosis (TB). To deal with this public health threat, the National TB Program introduced rapid molecular diagnostic tests such as Xpert MTB/RIF (Xpert) and line probe assays (LPAs) for first-line and second-line drugs. We documented the scale-up of Xpert and LPAs from 2012–2019 and assessed whether this led to an increase in patients with laboratory-confirmed multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) and extensively drug-resistant TB (XDR-TB). This was a descriptive study using secondary program data. The numbers of GeneXpert instruments cumulatively increased from six to sixty-seven, resulting in annual assays increasing from 5574 to 107,330. A broader use of the technology resulted in a lower proportion of tests detecting Mycobacterium tuberculosis with half of the positive results showing rifampicin resistance. LPA instruments cumulatively increased from two to thirteen; the annual first-line assays for MDR-TB increased from 2582 to 6607 while second-line assays increased from 1435 in 2016 to 6815 in 2019 with about one quarter to one third of diagnosed patients showing second-line drug resistance. Patient numbers with laboratory-confirmed MDR-TB remained stable (from 1728 to 2060) but there was a large increase in patients with laboratory-confirmed XDR-TB (from 31 to 696). Programmatic implications and ways forward are discussed.

Suggested Citation

  • Sharofiddin Yuldashev & Nargiza Parpieva & Salikhdjan Alimov & Laziz Turaev & Khasan Safaev & Kostyantyn Dumchev & Jamshid Gadoev & Oleksandr Korotych & Anthony D. Harries, 2021. "Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?," IJERPH, MDPI, vol. 18(9), pages 1-14, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:9:p:4685-:d:545034
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    Citations

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    Cited by:

    1. Jamshid Gadoev & Damin Asadov & Anthony D. Harries & Ajay M. V. Kumar & Martin Johan Boeree & Araksya Hovhannesyan & Lianne Kuppens & Askar Yedilbayev & Oleksandr Korotych & Atadjan Hamraev & Kallibek, 2021. "Factors Associated with Unfavourable Treatment Outcomes in Patients with Tuberculosis: A 16-Year Cohort Study (2005–2020), Republic of Karakalpakstan, Uzbekistan," IJERPH, MDPI, vol. 18(23), pages 1-19, December.

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