PARIS, Oct 26, 2006 (AFP) - A new study published on Thursday casts light on perilous drug-resistant strains of tuberculosis that have erupted in South Africa, reaping a mortal harvest among people with the AIDS virus.
The prevalence of these resistant strains is far wider than previously thought, according to the paper, published online by the British health journal The Lancet.
The team of investigators, from the United States and South Africa, tested patients with suspected tuberculosis in KwaZulu-Natal province for the multidrug resistant (MDR) strain of TB and for so-called extensively drug-resistant (XDR) strain.
MDR strains thwart the first line of antibiotics that are conventionally used to treat TB.
XDR strains are a newly discovered mutation of the TB germ that not only defeat the first line of drugs but the second line too, leaving doctors with a shrinking, preciously-hoarded arsenal of medications.
Of 1,539 people whose sputum was tested by culturing in a lab, 542 tested positive for the TB bacterium. Of these, 221 had MDR TB and 53 of these had XDR.
The study, lead-authored by Yale University's Neel Gandhi, ran from January 2005 to March 2006 in the Msinga sub-district of KwaZulu-Natal.
The rate of drug-resistant strains is far higher than previous estimates. In 2002, MDR TB among new patients in KwaZulu-Natal was put at only 1.7 percent, and another study which ran from 2003 to 2006 put it at nine percent.
All of the sick patients who were tested for HIV were co-infected with the virus, and all but one died. They survived on average just 16 days from the time the specimen was collected.
A genetic ID of the TB germs suggested that the patients had been infected recently, and that some of them had been infected while in hospital, the study added.
"The findings show the devastating effect of XDR tuberculosis on patients and health-care workers, its alarmingly high mortality rates in those co-infected with HIV and rapid nosocomial [hospital-borne] spread," said TB experts Annelies Van Rie and Donald Enarson in a commentary on the paper.
Around 450,000 new MDR TB cases are estimated to occur every year, according to estimates published in September by the World Health Organisation (WHO). The WHO believes that around nine million TB infections occur annually.
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