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Epidémiologie de la tuberculose et de la résistance aux antituberculeux

Abstract : Tuberculosis (TB) control is a major global public health issue. We used existing surveillance systems in two countries with different epidemiological profiles of tuberculosis (France and China) to evaluate patient management and antituberculosis drug resistance. In France, we first analyzed primary isoniazid monoresistance according to birth cohorts, demonstrating higher resistance rates among cohorts of young patients born in France. This result suggests recent transmission of such strains in France. Data currently available in the networks do not allow for further analysis to explain this increase (i.e. parental origins, exposure type, circulation of a particular clonal strain). In a second work, we showed that rifampin monoresistance incidence rate was very low (<1%), that its management was heterogeneous, and its treatment success rate not satisfactory. We suggest to implement a program identical to the one established for the management of multidrug resistant TB. In China, using a regional surveillance network, we confirmed that cough and belonging to a vulnerable population were risk factors for delayed diagnosis. The training of healthcare workers and patient's access to healthcare must be improved. Surveillance networks are key tools for collecting data, permitting the establishment of indicators of epidemiological TB characteristics, the basis of tuberculosis control programs
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  • HAL Id : tel-00833269, version 1


Vanina Meyssonnier. Epidémiologie de la tuberculose et de la résistance aux antituberculeux. Santé publique et épidémiologie. Université Pierre et Marie Curie - Paris VI, 2012. Français. ⟨NNT : 2012PAO66665⟩. ⟨tel-00833269⟩



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