Compliance with treatment guidelines is essential to achieve successful outcomes in tuberculosis patients. Thus, we assessed if multidrug-resistant tuberculosis treatment practices from 2012–2018 in Uzbekistan were compliant with national guidelines in terms of regimens prescribed, weight-based drug dosages used, and documentation of treatment changes (such as prolongation of intensive phase, change of drugs, and their reasons) in the treatment card and Consilium form. A total of 1481 patients were included. Of them, only 25% received standardized regimens as per guidelines and the remaining received individualized regimens. There was an increasing trend in using standardized regimens from 2% in 2012 to 44% in 2018. Compliance to recommended weight-based drug dosages was observed in 85% of the patients during the intensive phase and 84% in the continuation phase—ranged 71–91% over the years. Prolongation of the intensive phase was done in 42% of patients. The treatment was changed in 44% of patients during the intensive phase and 34% of patients during the continuation phase. The documentation of treatment changes was suboptimal (42–75%) during the initial years (2012–2014); however, it improved significantly during later years (86–100%). Future research should explore reasons for non-compliance so that the quality of patient care can be improved.

Poor adherence tо drug-resistant tuberculosis (DR-TB) treatment is а well known public health problem worldwide. Exploration of factors associated with low DR-TB treatment adherence is important for improving the care of the patients. The aim of this study was to assess the adherence of DR-TB patients during the intensive phase of hospital treatment by using the validated eight-item Morisky Medication Adherence Scale (MMAS-8) and to study the socio-demographic and clinical factors associated with treatment adherence. A total of 179 DR-TB patients were included in study. This was an analytical cross-sectional study exploring period of 2019-2020. Data was collected from patients’ histories and using the MMAS-8. Among 141 patients who were answered questionnaire the high level of DR-TB treatment adherence was observed in 19%, average level was in 40% and low in 41% of patients (Figure). The analysis showed that socio-demographic variables like of being older, lack of family, alcohol user were significantly related to average and low adherence. Clinical factors such as relapse DR-TB and cases with focal, disseminated and fibrocavernous types of DR-TB were also associated with average and low DR-TB treatment adherence. Future research on DR-TB treatment adherence is needed to find potential causes for increasing adherence to DR-TB treatment.

Compliance with treatment guidelines is crucial for effective and successful treatment of multidrug-resistant tuberculosis (MDR-TB). Thus, we assessed if MDR-TB treatment practices in Uzbekistan from 2012-18 were compliant with the national treatment guidelines in terms of 1) prescription of initial standard treatment regimens, 2) correct weight-based drug and 3) correct documentation of treatment changes (prolongation of intensive phase and regimen changes during both phases of treatment). Data of 1481 adult MDR TB patients were analyzed. Overall, 25% of patients were treated using the standardized regimens in compliance with the national guidelines: there was an increasing trend from 2% in 2012 to 44% in 2018 (Figure). Compliance to recommended weight-based drug dosages was observed in 85% of the patients during intensive phase and 84% in continuation phase – ranged between 71% and 91% over the years. The prolongation of the intensive phase was done in 42% of patients. The treatment was changed in 44% of patients during the intensive phase and 34% during the continuation phase. The documentation of treatment changes was suboptimal during the initial years (42-75%), however it improved significantly during later years (86-100%). Future research should explore reasons for non-compliance so that quality of patient care can be improved.

Introduction: On March 16, 2020, a quarantine was declared in Uzbekistan and restrictions began to be introduced, one of which was a ban on people over 65 years of age being in public places. The aim: is to study the effectiveness of pulmonary TB treatment in the group over 65 years of age during the COVID-19 pandemic. Study method: Retrospective analytical study included data from 222 outpatient cards of patients over 65 years of age with pulmonary TB, registered in TB dispensaries in Tashkent, Uzbekistan in March-December 2019-2020-2021. Study results: The number of identified cases in the group of patients with pulmonary TB over 65 years of age decreased by 34.8% in 2020 and by 23.9% in 2021 compared to 2019. Among patients with drug-sensitive (DS) TB, a decrease of successful treatment outcomes (cured+treatment completed) was detected by 6.1% in 2020 and by 16.8% in 2021 compared to 2019. There was unsuccessful outcomes such treatment failed+deaths an increased by 8.4% in 2020 and 12.2% in 2021 and lost to follow-up+not evaluated an increased by 4.6% in 2021 compared to 2019. In a cohort with drug-resistant (DR) TB an increase successful treatment outcomes cases from 47.1% in 2019 to 80.0% in 2020 and a decrease treatment failed+deaths cases from 41.2% in 2019 to 20.0% in 2020 was detected. Though in this cohort group in 2019 and 2021 there was increase lost to follow-up+not evaluated cases from 11.8% to 33.3%. Conclusion: The study demonstrated the vulnerability of patients over 65 years of age during the COVID-19 pandemic, which was determined by a decrease the frequency of successful treatment outcomes in DS patients, and an increase the frequency of unfavorable outcomes in both DS and DR patients.

Tuberculosis (TB) is one of the ten leading causes of death worldwide. The COVID-19 pandemic led to a reduction in outpatient and inpatient services due to the redistribution of medical personnel and increased laboratory research to combat COVID-19, which affected the solution of problems in phthisiology. The aim of the study - to assess the impact of the COVID-19 pandemic on the fight against TB in Tashkent, Uzbekistan during the period of strict quarantine from March to the end of 2020. The study included all adult patients with TB registered during March-December in 2019, 2020 and 2021. Data collected from 1775 patients, of which 1066 (60%) were men. According to the types of the current TB episodes patients were distributed as follows in the Table. According to the spectrum of drug sensitivity the TB patients were distributed as follows (Figure). During the period of strict quarantine from March to the end of 2020, compared to 2019, the number of identified TB patients in Tashkent city decreased by 22%.