The burden of tuberculosis drug resistance in Eastern Europe: The Moldavian experience

Aims: Surveillance the TB drug resistance on the national level and its impact upon public health in the Republic of Moldova; The objective: to characterize the evolution of tuberculosis drug resistance in Moldova (2001-2011). Methods. The study was retrospective, being based on the assessment results of M.tuberculosis complex drugs resistance obtained in the reference laboratories from the country. Results. Prevalence of MDRTB among New TB cases increase from 6.3% in 2001 up to 26.4% in 2011. Trough previously treated patients (relapses, re-treatment after default, re-treatment after failure, chronic) prevalence of MDR TB was detected in 37.7% cases in 2001 and 64.3% cases in 2011. Extensively drug-resistant tuberculosis (XDR-TB) is present in some territories. The rate of XDR TB among the patients with MDR TB is 6.1% (2010). The prevalence of TB-HIV co-infection in country is 5.4%. The prevalence of MDRTB among all TB-HIV is higher such from HIV negative patients (67.8%). Reasons of high level of TB resistance in Moldova: poor in infection control in TB hospitals -exogenous re-infection of TB patients; low compliance of treatment; the lack of a rigid control of TB patients, TB/HIV co-infection. Conclusions: At the current stage MDR TB is a serious problem for National TB Program, bringing serious public health and economic consequences. It is a very alarming phenomenon, because the success of treatment (with first-line drugs) for this form of TB is less effective than for the susceptible tuberculosis and the accumulation of a greater number of resistant strains in society can lead to the infection of population and to an increase in the number of patients with MDR&XDR TB.