Multidrug-resistant tuberculosis and treatment outcomes in Kazakhstan, Moldova, Ukraine, Georgia, and Kyrgyzstan

The <bold>purpose</bold> of our research was to study multidrug-resistant tuberculosis (MDR-TB) and treatment outcomes in Kazakhstan (KZ), Moldova (MD), Ukraine (UA), Georgia (GE), and Kyrgyzstan (KG). <bold>Materials and methods:</bold> This is a prospective study from 2020 to 2021 of patients with culture-confirmed pulmonary MDR-TB. The study was conducted in the main regional or national tuberculosis (TB)-institutions of KZ, MD, UA, GE, and KG and data were extracted from the NIAID TB-portal. From KZ (1 region) and UA (15 regions), data was only available from some areas due to the population density and large area of the country. <bold>Results:</bold> Our study included 2667 patients with MDR-TB (including 770 (28.9%) - patients had pre-X/XDR-TB (pre-Extensively/Extensively drug-resistant TB)). Most were from UA (1989,74.6%) and KZ (372,13.9%) while fewer were from MD(108,4%), GE(168,6.4%), and KG(30,1.1%). When comparing proportions of MDR-,pre-XDR- and XDR-TB for each country, pre-X/XDR-TB was observed in 1.8% of patients from GE,10%-KG,21.8%-KZ,14.8%-MD, and 33.5%-UA. UA had a significantly large proportion of pre-X/XDR-TB compared to other countries (p<0.05). Regarding treatment outcomes, treatment success (completed and cured) was noted for 1307 (49%) patients, with KZ - 69.3%, MD - 67.6%, UA - 40%, GE - 80% and KG - 86.6%. Treatment outcomes were affected by the beginning of the war in UA, as many patients completed treatment in 2022. <bold>Conclusions:</bold> KZ, MD, UA, GE, and KG have a high prevalence of TB with MDR-TB. Comparing data from these five countries, UA have a higher prevalence of pre-X/XDR-TB, which is likely the main reason for the worse treatment outcomes observed.