Epidemiologic surveillance system for drug-resistant tuberculosis in the Republic of Tajikistan: problems and ways of its improvement

Objective. Development of recommendations for improving the system of epidemiological surveillance of drug-resistant tuberculosis. Material and methods. The surveillance system for drug-resistant tuberculosis in Dushanbe and the Rudaki district was evaluated, following the guidelines provided by the US Centers for Disease Control and Prevention (CDC). Results. The tuberculosis (TB) surveillance framework is multifaceted with multiple reporting tiers. The reporting forms provided by the government do not provide information on the indicators needed to track the spread of multidrug-resistant TB. An evaluation of timeliness revealed that appropriate treatment commenced promptly in 52% of cases (42 out of 80): 54% (29 out of 54 cases) in Dushanbe and 50% (13 out of 26) in the Rudaki district. Delays were associated with multiple drug resistance in comparison to other types of drug resistance (OR-4.3; 95% CI 1.7-11.1), outpatient in contrast to inpatient treatment (OR-5.3; 95% CI 1.1-27.0). Conclusion. The epidemiological surveillance system for TB with drug-resistant strains in both regions achieves its intended goals and objectives. However, the system’s flexibility, timeliness, and acceptability require further refinement.