TY - JOUR
T1 - Tuberculosis report among injection drug users and their partners in Kazakhstan
AU - Hermosilla, S.
AU - El-Bassel, N.
AU - Aifah, A.
AU - Terlikbayeva, A.
AU - Zhumadilov, Z.
AU - Berikkhanova, K.
AU - Darisheva, M.
AU - Gilbert, L.
AU - Schluger, N.
AU - Galea, S.
N1 - Funding Information:
The study was funded to Dr. Nabila El-Bassel, NIDA grant number 1R01DA022914 . The funder had no role in the development or presentation of findings.
Funding Information:
The authors would like to acknowledge the study participants who shared their time and their experiences with Project Renaissance. They would also like to thank project staff members, Saltanat Yegeubayeva in particular, who assisted with recruitment, data collection, and project implementation. On-going research support provided by the Kazakhstan Ministry of Education and Science.
Publisher Copyright:
© 2015 The Royal Society for Public Health.
Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - 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. Study design: Cross-sectional study. 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 (odds ratio (OR) 7.26, 95% confidence interval (CI): 1.73, 30.43), male (OR 5.53, 95% CI: 2.74, 11.16), have a shorter duration of injection drug use (OR 0.17, 95% CI: 0.04, 0.65), have received high social support from their significant other (OR 2.13, 95% CI: 1.03, 4.40) and more likely (non-significantly) to have been incarcerated (OR 7.03, 95% CI: 0.64, 77.30). 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.
AB - 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. Study design: Cross-sectional study. 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 (odds ratio (OR) 7.26, 95% confidence interval (CI): 1.73, 30.43), male (OR 5.53, 95% CI: 2.74, 11.16), have a shorter duration of injection drug use (OR 0.17, 95% CI: 0.04, 0.65), have received high social support from their significant other (OR 2.13, 95% CI: 1.03, 4.40) and more likely (non-significantly) to have been incarcerated (OR 7.03, 95% CI: 0.64, 77.30). 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.
KW - Central Asia
KW - Incarceration
KW - Injection drug users
KW - Kazakhstan
KW - Social support
KW - Tuberculosis
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U2 - 10.1016/j.puhe.2015.01.022
DO - 10.1016/j.puhe.2015.01.022
M3 - Article
C2 - 25795015
AN - SCOPUS:84930277832
VL - 129
SP - 569
EP - 575
JO - Public Health
JF - Public Health
SN - 0033-3506
IS - 5
ER -