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Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case-control study and recommendations.

Maguire, H; Brailsford, S; Carless, J; Yates, M; Altass, L; Yates, S; Anaraki, S; ... Bothamley, G; + view all (2011) Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case-control study and recommendations. Euro Surveill , 16 (13)

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Abstract

We conducted a case–control study to examine risk factors for isoniazid-monoresistant Mycobacterium tuberculosis in an ongoing outbreak in London. Cases were defined as individuals with an isoniazid-monoresistant strain diagnosed from 1995 to the third quarter of 2006 with an indistinguishable restriction fragment length polymorphism (RFLP) or mycobacterial interspersed repetitive unit (MIRU)-variable number tandem repeats (VNTR) pattern who were resident in or had epidemiological links with London. Controls were all other individuals reported with tuberculosis to the Health Protection Agency London regional epidemiology unit or the HPA London TB Register during 2000 to 2005. Of 293 cases, 153 (52%) were sputum smear-positive compared with 3,266 (18%) of controls. Cases were more likely to be young adults (aged between 15 and 34 years), born in the United Kingdom (OR: 2.4; 95% CI: 1.7–3.4) and of white (OR: 2.9; 95% CI: 1.8–4.8) or black Caribbean (OR: 12.5; 95% CI: 7.7–20.4) ethnicity, a prisoner at the time of diagnosis (OR: 20.2; 95% CI: 6.7–60.6), unemployed (OR: 4.1; 95% CI: 3.0–5.6), or a drug dealer or sex worker (OR: 187.1; 95% CI: 28.4–1,232.3). A total of 113 (39%) of cases used drugs and 54 (18%) were homeless. Completion of treatment gradually improved in cases from 55% among those diagnosed up to the end of 2002 compared with 65% by the end of 2006. Treatment completion increased from 79% to 83% in controls from 2000 to 2005. There are complex social challenges facing many cases in this outbreak that need to be addressed if medical interventions are to be successful.

Type: Article
Title: Large outbreak of isoniazid-monoresistant tuberculosis in London, 1995 to 2006: case-control study and recommendations.
Location: Sweden
Keywords: Adolescent, Adult, Age Distribution, Aged, Antimalarials, Case-Control Studies, Disease Outbreaks, Drug Resistance, Bacterial, Female, Humans, Isoniazid, London, Male, Middle Aged, Mycobacterium tuberculosis, Retrospective Studies, Risk Factors, Sex Distribution, Socioeconomic Factors, Surveys and Questionnaires, Tuberculosis, Tuberculosis, Multidrug-Resistant, Young Adult
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: http://discovery.ucl.ac.uk/id/eprint/1384671
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