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Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance

Conaty, SJ; Hayward, AC; Story, A; Glynn, JR; Drobniewski, FA; Watson, JM; (2004) Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance. EPIDEMIOL INFECT , 132 (6) 1099 - 1108. 10.1017/S0950268804002869. Green open access

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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 (1993-1994 and 1998-2000) 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).

Type: Article
Title: Explaining risk factors for drug-resistant tuberculosis in England and Wales: contribution of primary and secondary drug resistance
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0950268804002869
Publisher version: http://dx.doi.org/10.1017/S0950268804002869
Language: English
Additional information: © 2004 Cambridge University Press
Keywords: NEW-YORK-CITY, UNITED-STATES, MYCOBACTERIUM-TUBERCULOSIS, HIV SEROPREVALENCE, PATTERNS, LONDON, EPIDEMIOLOGY, REINFECTION, POPULATION, GERMANY
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 Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/181376
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