The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2016
Multidrug-resistant tuberculosis in Norway: a nationwide study, 1995-2014.
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Jensenius M, Winje B A, Blomberg B, Mengshoel A T, Lippe B von der, Hannula R, Bruun J N, Knudsen P K, Rønning J O, Heldal E, Dyrhol-Riise A M
Аннотация
SETTING: The management of multidrug-resistant tuberculosis (MDR-TB) is strictly regulated in Norway. However, nationwide studies of the epidemic are lacking.
OBJECTIVE: To describe the MDR-TB epidemic in Norway over two decades.
DESIGN: Retrospective analysis of data on MDR-TB cases in Norway, 1995-2014, obtained from the national registry, patient records and the reference laboratory, with genotyping and cluster analysis data. Data for non-MDR-TB cases were collected from the national registry.
RESULTS: Of 4427 TB cases, 89 (2.0%) had MDR-TB, 7% of whom had extensively drug-resistant TB (XDR-TB) and 24% pre-XDR-TB. Of the 89 MDR-TB cases, 96% were immigrants, mainly from the Horn of Africa or the former Soviet Union (FSU); 37% had smear-positive TB; and 4% were human immunodeficiency virus co-infected. Of the 19% infected in Norway, the majority belonged to a Delhi/Central Asian lineage cluster in a local Somali community. Among the MDR-TB cases, smear-positive TB and FSU origin were independent risk factors for XDR/pre-XDR-TB. Treatment was successful in 66%; 17% were lost to follow-up, with illicit drug use and adolescence being independent risk factors. Forty-four per cent of patients treated with linezolid discontinued treatment due to adverse effects.
CONCLUSION: MDR-TB is rare in Norway and is predominantly seen in immigrants from the Horn of Africa and FSU. Domestic transmission outside immigrant populations is minimal.
OBJECTIVE: To describe the MDR-TB epidemic in Norway over two decades.
DESIGN: Retrospective analysis of data on MDR-TB cases in Norway, 1995-2014, obtained from the national registry, patient records and the reference laboratory, with genotyping and cluster analysis data. Data for non-MDR-TB cases were collected from the national registry.
RESULTS: Of 4427 TB cases, 89 (2.0%) had MDR-TB, 7% of whom had extensively drug-resistant TB (XDR-TB) and 24% pre-XDR-TB. Of the 89 MDR-TB cases, 96% were immigrants, mainly from the Horn of Africa or the former Soviet Union (FSU); 37% had smear-positive TB; and 4% were human immunodeficiency virus co-infected. Of the 19% infected in Norway, the majority belonged to a Delhi/Central Asian lineage cluster in a local Somali community. Among the MDR-TB cases, smear-positive TB and FSU origin were independent risk factors for XDR/pre-XDR-TB. Treatment was successful in 66%; 17% were lost to follow-up, with illicit drug use and adolescence being independent risk factors. Forty-four per cent of patients treated with linezolid discontinued treatment due to adverse effects.
CONCLUSION: MDR-TB is rare in Norway and is predominantly seen in immigrants from the Horn of Africa and FSU. Domestic transmission outside immigrant populations is minimal.
Предметные рубрики MeSH
AdolescentAdultAfricaAntitubercular AgentsChildChild, PreschoolCluster AnalysisEmigrants and ImmigrantsEpidemicsExtensively Drug-Resistant TuberculosisFemaleFollow-Up StudiesGenotyping TechniquesHIV InfectionsHumansLinezolidLost to Follow-UpMaleMiddle AgedNorwayRetrospective StudiesRisk FactorsTuberculosis, Multidrug-ResistantUSSRYoung Adult