Medical and Social Portrait of a Tuberculosis Patient with Extensive Drug Resistance

The article presents a comparative analysis of the medical, social and clinical and epidemiological characteristics of patients with tuberculosis, the causative agent of which has broad (XDR-TB) and pre-wide (pre-XDR-TB) drug resistance in the Kyrgyz Republic. The study included 89 patients, 38 of them with XDR-TB and 51 with pre-XDR-TB, who were treated in national tuberculosis hospitals. XDR-TB patients were mostly middle-aged and elderly men, characterized by a high level of social vulnerability: most of them were unemployed, single, had only secondary education, and often did not have their own housing. The clinical structure of this group was dominated by infiltrative tuberculosis (44.7%) and fibrous-cavernous tuberculosis (26.3%). The complication rate was significantly higher than among patients with pre-XDR-TB, in particular, respiratory failure was observed in 26.3% of patients. Concomitant diseases were detected in the majority, mainly diabetes mellitus and anemia. An important feature was the high proportion of relapses and ineffectiveness of treatment, especially when using second-line drugs (47.4%). Patients with pre-XDR-TB turned out to be younger, and men also predominated among them (55.2%). The leading clinical form was infiltrative tuberculosis (66.7%). The proportion of new cases in this group was 49%, indicating continued active transmission of the infection. Complications were reported less frequently (9.8%), and the social profile was slightly more favorable compared to patients with XDR-TB, although unemployment remained high (64.7%). The results of the study indicate that XDR-TB patients represent the most severe clinical and social category, requiring an integrated approach that includes intensive medical care, social support, and relapse prevention. Patients with pre-XDR-TB need strategies aimed at increasing treatment adherence and preventing disease progression. The data obtained can serve as a basis for the development of differentiated measures within the framework of the national tuberculosis control program.