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Mycobacterium tuberculosis Drug Resistance, Abkhazia

机译：结核分枝杆菌耐药性，阿布哈兹

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To the Editor: Drug-resistant tuberculosis (TB) has been identified as a major problem in the former Soviet Union, and was recently surveyed in the Aral Sea regions of Dashoguz (Turkmenistan) and Karakalpakstan (Uzbekistan) (1). However, few data are available for the Caucasian region and published reports have focused mainly on prisons (2,3). We report a drug resistance survey for first- and second-line anti-TB drugs conducted in Abkhazia, a Caucasian region of 8,600 km2 with approximately 250,000 inhabitants, at the western end of Georgia on the Black Sea. The collapse of the Soviet Union lead to disruption of TB control activities in all Eastern bloc regions (4). In Abkhazia, the shortage and poor quality of drugs, self-medication, and poor adherence to the therapy became even more evident during the war with Georgia in 1993 and the international embargo that followed. A TB program based on the World Health Organization/International Union against Tuberculosis and Lung Disease (WHO/IUATLD) recommendations was initiated in Abkhazia with the support of Médecins Sans Frontières (MSF) in 1999. In 2000, monitoring of drug resistance was started for new cases and previously treated case-patients. The study was performed in collaboration with the Guliripchi TB Hospital, MSF, and the Istituto Superiore di Sanità (ISS), a WHO/IUATLD Supranational Reference Laboratory for anti-TB drug resistance.
机译：致编辑：耐药性结核病（TB）在前苏联已被确定为主要问题，最近在达沙古兹（土库曼斯坦）和卡拉卡尔帕克斯坦（乌兹别克斯坦）的咸海地区进行了调查（1）。但是，关于高加索地区的数据很少，公开的报告主要集中在监狱（2,3）。我们报告了在黑海佐治亚州西端的阿布哈兹地区进行的一线和二线抗结核药物耐药性调查，阿布哈兹是一个占地8600平方公里的白种人地区，约有25万居民。苏联解体导致东部所有地区的结核病控制活动中断（4）。在阿布哈兹，在1993年与格鲁吉亚的战争以及随后的国际禁运期间，毒品的短缺和药品质量差，自我用药以及对治疗的依从性差变得更加明显。在世界无国界医生组织（MSF）的支持下，于1999年在阿布哈兹启动了一项基于世界卫生组织/国际抗结核和肺病联盟（WHO / IUATLD）建议的结核病计划。2000年，开始监测其耐药性新病例和先前治疗过的病例患者。该研究是与无国界医生Guliripchi TB医院以及世界卫生组织/ IUATLD抗结核药物超参考实验室Istituto Superiore diSanità（ISS）合作进行的。

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