Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors

The levels of MDR-TB documented in Belarus are among the highest ever recorded globally. Rapid testing for drug resistance for all patients with TB, a revised treatment regimen for patients with a history of previous TB treatment, an uninterrupted supply of second-line drugs, and measures to reduce the nosocomial transmission of M. tuberculosis, including the shortened hospitalization of non-contagious patients, should be rapidly introduced. Furthermore, the positive association between MDR-TB and HIV infection calls for stronger collaboration between TB and HIV control programmes to provide greater support to co-infected patients. To improve TB treatment adherence and reduce opportunities for the development of MDR-TB, the integration of treatment for alcohol use disorders with TB services and the strengthening of patient incentives and enablers should also be explored.