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International public health authorities have signaled the need for greater vigilance in controlling drug-resistant and drug-susceptible tuberculosis (TB) in Russia.
In the August 6 Morbidity and Mortality Weekly Report, investigators from the World Health Organization, the US Centers for Disease Control and Prevention, and other institutions reported on a substantial increase in primary multidrug-resistant TB (P-MDRTB) in Ivanovo oblast, a district of 1.3 million people about 165 miles northeast of Moscow. Despite implementation of short-course directly observed therapy in 1995 in Ivanovo, the percentage of new cases that were identified as P-MDRTB increased from 3.8% in 1996 to 9.4% in 1998. The investigation also showed that patients with resistant and susceptible TB had high rates of previous incarceration, unemployment, alcoholism, and homelessness.
Voelker R. TB Control in Russia. JAMA. 1999;282(10):933. doi:10.1001/jama.282.10.933-JWM90007-2-1