Tuberculosis Report among Injection Drug Users & Their Partners in Kazakhstan
OBJECTIVES:
Tuberculosis
(TB) is a major threat to global public health. Kazakhstan has the second
highest percentage of multidrug-resistant tuberculosis (MDR-TB) cases among
incident tuberculosis cases in the world (WHO 2013). A high burden of MDR-TB
suggests TB prevention, control, and treatment programs are failing. This study
provides an epidemiologic profile of TB among injection drug users (IDUs), a
high-risk and chronically underserved population, in Kazakhstan.
METHODS:
The
authors studied the characteristics and risk environment of IDUs with
self-reported previous active TB and their primary sexual partners in Almaty,
Kazakhstan. 728 individuals (364 couples) participated in a couple-based study
in 2009.
RESULTS:
16.75% of
participants reported at least one positive TB test (x-ray) in their lifetime.
In a multivariable logistic regression adjusting for couple-based sampling,
persons with positive TB test were significantly more likely to be older, male, have a shorter duration of injection drug use, have received high social support from their significant other and more likely (non-significantly) to have been
incarcerated.
CONCLUSIONS:
Older
men with a history of incarceration and recent injection drug use were more
likely to have positive TB test in Kazakhstan. Social network support, while
potentially positive for many aspects of population health, may increase risk
of TB among IDUs in this context. Public health policies that target high-risk
populations and their at-risk networks may be necessary to stem the rise of
MDR-TB in Central Asia.
- 1Columbia University Medical Center, USA. Electronic address: sh2405@columbia.edu.
- 2Columbia University School of Social Work, USA.
- 3Global Health Research Center of Central Asia, USA.
- 4Nazarbayev University, Kazakhstan.
- 5Columbia University Medical Center, USA.
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