Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Conaty, SJ; Hayward, AC; Story, A; Glynn, JR; Drobniewski, FA; Watson, JM; (2004) Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance. Epidemiology and infection, 132 (6). pp. 1099-108. ISSN 0950-2688

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: Drug-resistant tuberculosis can be transmitted (primary) or develop during the course of treatment (secondary). We investigated risk factors for each type of resistance. We compared all patients in England and Wales with isoniazid- and multidrug-resistant tuberculosis in two time-periods (1993-1994 and 1998-2000) with patients with fully sensitive tuberculosis, examining separately patients without and with previous tuberculosis (a proxy for primary and secondary drug-resistant tuberculosis). Patients with previous tuberculosis smear positivity and arrival in the United Kingdom <5 years were strongly associated with multidrug resistance and isoniazid resistance. In patients with no previous tuberculosis HIV infection, residence in London and foreign birth were risk factors for multidrug resistance, and non-white ethnicity, residence in London and HIV infection for isoniazid resistance. Risk factors for each type of resistance differ. Elevated risks associated with London residence, HIV positivity, and ethnicity were mainly seen in those without previous tuberculosis (presumed transmission).<br/>

Item Type: Article
Keywords: New-york-city, united-states, mycobacterium-tuberculosis, hiv, seroprevalence, patterns, london, epidemiology, reinfection, population, germany, Adolescent, Adult, Aged, Aged, 80 and over, Antitubercular Agents, pharmacology, Case-Control Studies, Child, Child, Preschool, Drug Resistance, Bacterial, Drug Resistance, Multiple, Emigration and Immigration, England, epidemiology, Female, Humans, Incidence, Infant, Infant, Newborn, Isoniazid, pharmacology, London, epidemiology, Male, Middle Aged, Population Surveillance, Research Support, Non-U.S. Gov't, Risk Factors, Tuberculosis, Pulmonary, drug therapy, Wales, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Antimicrobial Resistance Centre (AMR)
TB Centre
PubMed ID: 15635967
Web of Science ID: 226082100012
URI: http://researchonline.lshtm.ac.uk/id/eprint/13938


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