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- Title
Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance.
- Authors
S. J. CONATY; A. C. HAYWARD; A. STORY; J. R. GLYNN; F. A. DROBNIEWSKI; J. M. WATSON
- Abstract
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 (19931994 and 19982000) 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).
- Subjects
UNITED Kingdom; TUBERCULOSIS; DISEASE risk factors; HIV infections; ISONIAZID
- Publication
Epidemiology & Infection, 2004, Vol 132, Issue 6, p1099
- ISSN
0950-2688
- Publication type
Article
- DOI
10.1017/s0950268804002869