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Is tuberculosis becoming untreatable?

Is tuberculosis becoming untreatable?

Trends in drug-resistant tuberculosis around the world

Brussels, 18 December 2008. Globally, the proportion of people who become ill with tuberculosis (TB) each year is stable or decreasing. However, because of population growth, the absolute number of new TB cases is rising. Usually, it can be treated with antibiotics but some forms of the disease have emerged that do not respond to these "first-line drugs". They are known as multidrug-resistant tuberculosis and can only be cured with "second-line" drugs which are more expensive and have worse side-effects. Extensively drug-resistant tuberculosis refers to even more dangerous forms of the disease that are resistant to both first- and second-line drugs and are more difficult to treat.

The trends in drug-resistant tuberculosis are explored by the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Diseases (IUATLD) in their Fourth Global Report on "Anti-Tuberculosis Drug Resistance in the World".

GreenFacts made a faithful summary of this WHO/IUATLD Global Report. As of today, this full summary is published and accessible free of charge at www.greenfacts.org/en/tuberculosis/.

Highlights of WHO/IUALDT report on Anti-Tuberculosis Drug Resistance in the World

In 2006, approximately half a million new cases of multidrug-resistant tuberculosis (MDR-TB) emerged in the world, with the disease affecting almost every country. The highest proportion of MDR-TB among all cases of tuberculosis is found in the former Soviet Union. In absolute numbers, the worst affected country is China.

Extensively drug-resistant tuberculosis (XDR-TB) can only be treated with a handful of drugs that are more expensive and have worse side-effects than the drugs used to treat multidrug-resistant tuberculosis. XDR-TB is widespread but is a particularly significant problem in countries of the former Soviet Union, where cases of extensive resistance are high both in absolute numbers and as a proportion of total TB cases.

There is a significant association between HIV and MDR-TB. The death rate in people who have both infections is high. In order to reduce the number of  people infected with both HIV and MDR-TB it is important to prevent transmission in places where infected people are in close contact with each other, such as hospitals and prisons.

Despite progress in information gathering, more laboratories and staff are still needed to measure the extent of drug-resistant tuberculosis. The network of supra-national reference laboratories must continue to offer practical help while individual countries improve their facilities.

To control MDR-TB, all countries need to increase their efforts to prevent transmission, detect cases as early as possible and register all patients into a suitable treatment programme. Methods to detect drug resistance quickly and new drugs to treat MDR-TB are urgently needed.

About GreenFacts

GreenFacts asbl/vzw is an independent, multi-stakeholder non-profit organization based in Belgium. Our mission is to bring complex scientific reports on health and the environment to the reach of non-experts.

We publish faithful summaries of authoritative international scientific reports. The summaries are written in a language for non-specialists and presented in a reader-friendly Three-Level Structure of increasing detail. GreenFacts' publications are freely available in several languages on www.greenfacts.org.

GreenFacts was created in 2001 by individuals from scientific institutions, environmental and health organizations, and businesses, who called for wider access to unbiased information on health and the environment.

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Katharine Eaton
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