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Open Access Highly Accessed Research article

Tuberculosis in Kazakhstan: analysis of risk determinants in national surveillance data

Assel Terlikbayeva1*, Sabrina Hermosilla6, Sandro Galea6, Neil Schluger6, Saltanat Yegeubayeva1, Tleukhan Abildayev2, Talgat Muminov3, Farida Akiyanova4, Laura Bartkowiak6, Zhaksybay Zhumadilov5, Almaz Sharman5 and Nabila El-Bassel6

Author Affiliations

1 Columbia University Global Health Research Center of Central Asia, 102 Luganskogo str, Almaty, 050059, Kazakhstan

2 National Center for Tuberculosis in Kazakhstan, 5 Bekhodjin str, Almaty, 050059, Kazakhstan

3 Kazakhstan National Association of TB Specialists, 5 Bekhodjin str, Almaty, 050059, Kazakhstan

4 Kazakhstan National Institute of Geography, 99 Pushkin str, Almaty, 050010, Kazakhstan

5 Nazarbayev University; address, 5 Kabanbay Batyr str, Astana, 010000, Kazakhstan

6 6) Columbia University in the City of New York, 1255 Amsterdam Avenue, New York, NY, 10027, USA

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BMC Infectious Diseases 2012, 12:262  doi:10.1186/1471-2334-12-262

Published: 18 October 2012

Abstract

Background

Development of tuberculosis (TB) is determined by various risk factors and the interactions of temporal and spatial distributions. The aim of this study was to identify the most salient risk factors for TB disease as well as multidrug resistant TB (MDR-TB) at the oblast (provincial) level in Kazakhstan.

Methods

Correlational and descriptive analyses were conducted at the oblast and national level using data provided by the country’s National Institute of Geography (NIG) and the National Tuberculosis Program (NTP). Reported incident case notification rates (CNRs) and prevalence vary by oblast, thus the study investigated which determinants contributed to this regional variation and compared burdens among oblasts.

Results

The results showed that while tuberculosis CNRs decreased over the study period, MDR-TB conversely increased. Two oblasts -Atyrauskaya and Mangystauskaya - presented especially significant anomalies with large decreases in TB incident CNRs coupled with comparatively large increases in MDR-TB incident CNRs.

Conclusion

Understanding the distribution of TB and MDR-TB cases and associated risk factors, especially the “unknown risk factor” categorization points to the need for future research.

Keywords:
Tuberculosis; Case notification rate (CNR); Prevalence; Risk factors; MDR-TB; Kazakhstan; Spatial distribution; Surveillance; National tuberculosis program (NTP); Oblast