Encouraging outcomes in the first year of a TB control demonstration program: Orel Oblast, Russia

Int J Tuberc Lung Dis. 2003 Nov;7(11):1045-51.


Setting: Orel, Russia.

Objective: To evaluate outcomes of tuberculosis (TB) patients treated in the first year of a TB control demonstration project using a revised strategy of directly observed treatment, short-course (DOTS). Standard methods recommended by World Health Organization (WHO) were adapted to include mycobacterial cultures.

Design: Retrospective cohort analysis of TB patients diagnosed between October 1999 and September 2000.

Results: Among 749 TB patients, 65% had bacteriologic confirmation of pulmonary TB, 31% were diagnosed clinically, and 4% had extra-pulmonary TB. Most (92%) had no previous TB treatment, but 8% were identified as retreatment cases. Of all patients, 41% had new sputum smear-positive TB. No patients were HIV-infected. Multidrug-resistant (MDR) TB levels were 3% among new and 17% among retreatment patients. Among new smear-positive patients, treatment success was 79% (72% cure, 7% completion); remaining outcomes were 8% failure, 3% default, 8% death, and 1% transfer. Success rates for new culture-positive and clinically diagnosed patients were 81% and 91%, respectively.

Conclusion: Despite historical differences, successful implementation of the revised TB strategy in Russia is possible. Treatment success rates were high, suggesting WHO targets of 85% cure for smear-positive patients is attainable. Obstacles include drug resistance and elevated death rates among smear-positive patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Cohort Studies
  • Directly Observed Therapy*
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retrospective Studies
  • Russia
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / prevention & control
  • Tuberculosis, Pulmonary / prevention & control*