Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
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Reuters (12.18.06) - Monday, December 18, 2006
Patricia Reaney
"There is increasing drug resistance in some parts of the world, namely the former Soviet Union and China," said Dr. Mario Raviglione of the World Health Organization (WHO). Together, China, Russia, and India account for half of all MDR-TB cases worldwide. "By having better data, we are able to recalculate estimates of six or seven years ago," he said.
Earlier estimates of MDR-TB infections put the annual figure at about 300,000 new cases. The more accurate estimate is 424,000 MDR-TB infections in 2004, reported researchers from WHO, CDC, and the Prince Leopold Tropical Institute in Antwerp, Belgium. The higher prevalence of MDR-TB coincides with quickly growing HIV epidemics in Eastern Europe and Asia. HIV patients are more vulnerable to opportunistic infections, with TB being a main cause of AIDS mortality.
MDR-TB rates have declined in Latvia, the United States, Hong Kong, and Cuba, the study found. But infections increased elsewhere, including Botswana and Tomsk Oblast, Russia.
MDR-TB is fueled by poor adherence to the long treatment needed to cure TB. MDR-TB is also a precursor to extremely drug-resistant TB (XDR-TB) strains, in which three or more second-line TB treatments are also not effective.
Health experts recommend improved TB control programs, especially diagnostic capabilities, where MDR-TB cases are high. Directly observed treatment strategies (DOTS), in which patient adherence to the drug regimens is monitored to ensure the entire course of treatment, is also recommended.
The full study, "Epidemiology of Anti-Tuberculosis Drug Resistance (The Global Project on Anti-Tuberculosis Drug Resistance Surveillance): An Updated Study," was published in The Lancet (2006;368(9553):2142-2154).
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