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Multidrug-resistant tuberculosis in Norway: a nationwide study, 1995-2014.

https://arctichealth.org/en/permalink/ahliterature289837
Source
Int J Tuberc Lung Dis. 2016 06; 20(6):786-92
Publication Type
Journal Article
Date
06-2016
Author
M Jensenius
B A Winje
B Blomberg
A T Mengshoel
B von der Lippe
R Hannula
J N Bruun
P K Knudsen
J O Rønning
E Heldal
A M Dyrhol-Riise
Author Affiliation
Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway.
Source
Int J Tuberc Lung Dis. 2016 06; 20(6):786-92
Date
06-2016
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Africa - ethnology
Antitubercular Agents - therapeutic use
Child
Child, Preschool
Cluster analysis
Emigrants and Immigrants
Epidemics
Extensively Drug-Resistant Tuberculosis - drug therapy - epidemiology
Female
Follow-Up Studies
Genotyping Techniques
HIV Infections - drug therapy - epidemiology
Humans
Linezolid - therapeutic use
Lost to Follow-Up
Male
Middle Aged
Norway - epidemiology
Retrospective Studies
Risk factors
Tuberculosis, Multidrug-Resistant - drug therapy - epidemiology
USSR - ethnology
Young Adult
Abstract
The management of multidrug-resistant tuberculosis (MDR-TB) is strictly regulated in Norway. However, nationwide studies of the epidemic are lacking.
To describe the MDR-TB epidemic in Norway over two decades.
Retrospective analysis of data on MDR-TB cases in Norway, 1995-2014, obtained from the national registry, patient records and the reference laboratory, with genotyping and cluster analysis data. Data for non-MDR-TB cases were collected from the national registry.
Of 4427 TB cases, 89 (2.0%) had MDR-TB, 7% of whom had extensively drug-resistant TB (XDR-TB) and 24% pre-XDR-TB. Of the 89 MDR-TB cases, 96% were immigrants, mainly from the Horn of Africa or the former Soviet Union (FSU); 37% had smear-positive TB; and 4% were human immunodeficiency virus co-infected. Of the 19% infected in Norway, the majority belonged to a Delhi/Central Asian lineage cluster in a local Somali community. Among the MDR-TB cases, smear-positive TB and FSU origin were independent risk factors for XDR/pre-XDR-TB. Treatment was successful in 66%; 17% were lost to follow-up, with illicit drug use and adolescence being independent risk factors. Forty-four per cent of patients treated with linezolid discontinued treatment due to adverse effects.
MDR-TB is rare in Norway and is predominantly seen in immigrants from the Horn of Africa and FSU. Domestic transmission outside immigrant populations is minimal.
PubMed ID
27155182 View in PubMed
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