Anti-tuberculosis drug resistance among tuberculosis patients in Ukraine and risk factors for MDR-TB

Ukraine is one of the 10 countries in the world with the highest MDR-TB burden. With technical support from WHO, the national TB programme conducted the first countrywide survey from November 2013 to May 2014 to identify MDR-TB levels and its risk factors. MDR-TB was detected in 24.1% (95% CI: 20.7– 27.6) of new patients and 58.1% (95% CI: 52.1– 64.1) of previously treated patients. Risk factors that were statistically significant for MDR-TB among new cases were: residence in the south-eastern part of the country (OR: 2.35); HIV (OR: 1.93); poor socioeconomic status (OR: 1.93,); illicit drug use (OR: 1.70); prior incarceration (OR: 1.44) and unemployment (OR: 1.43). Age was inversely associated with MDR-TB (OR: –0.81). Among previously treated patients, statistically significant higher odds of MDR-TB were found in women (OR: 2.40), in the groups aged 34–44 and 45–54 years (OR: 2.83 and 2.31, respectively), and in towns and rural areas with populations of less than 50 000 (OR: 3.44 and 2.54, respectively). The survey provides valuable data for MDR-TB programmatic management planning in Ukraine.