Multidrug-resistant tuberculosis (MDR-TB) hasemerged as a major threat to TB control, particularly in theformer Soviet Union. To determine levels of drug resistancewithin a directly observed treatment strategy (DOTS) pro-gram supported by Médecins Sans Frontières in tworegions in Uzbekistan and Turkmenistan, Central Asia, weconducted a cross-sectional survey of smear-positive TBpatients in selected districts of Karakalpakstan(Uzbekistan) and Dashoguz (Turkmenistan). High levels ofMDR-TB were found in both regions. In Karakalpakstan, 14(13%) of 106 new patients were infected with MDR-TB; 43(40%) of 107 previously treated patients were similarlyinfected. The proportions for Dashoguz were 4% (4/105patients) and 18% (18/98 patients), respectively. Overall,27% of patients with positive smear results whose infec-tions were treated through the DOTS program inKarakalpakstan and 11% of similar patients in Dashoguzwere infected with multidrug-resistant strains of TB onadmission. These results show the need for concertedaction by the international community to contain transmis-sion and reduce the effects of MDR-TB
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