New Survey Finds Highest Rates of
Drug-Resistant TB to Date
WHO News release 26feb2008
WASHINGTON DC /GENEVA — Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report published today. The report presents findings from the largest survey to date on the scale of drug resistance in tuberculosis.
Anti-tuberculosis drug resistance in the world
The report, "Anti-tuberculosis drug resistance in the world", is based on data collected between 2002 and 2006 on 90 000 TB patients in 81 countries. It found that extensively drug-resistant tuberculosis (XDR-TB), a virtually untreatable form of the respiratory disease, has been recorded in 45 countries.
The report also found a link between HIV infection and MDR-TB. Surveys in Latvia and Ukraine found nearly twice the level of MDR-TB among TB patients living with HIV compared with patients without HIV.
Based on the analysis of the survey data, WHO estimates there are nearly half a million new cases of MDR-TB a year, which is about 5% of nine million new TB cases of all types. The highest rate was recorded in Baku, the capital of Azerbaijan, where nearly a quarter of all new TB cases (22.3%) were reported as multidrug-resistant.
Proportions of MDR-TB among new TB cases were 19.4% in Moldova, 16% in Donetsk in Ukraine, 15% in Tomsk Oblast in the Russian Federation, and 14.8% in Tashkent in Uzbekistan. These rates surpass the highest levels of drug resistance published in the last WHO report in 2004. Surveys in China also suggest that MDR-TB is widespread there.
Frontal assault needed "TB drug resistance needs a frontal assault. If countries and the international community fail to address it aggressively now we will lose this battle," said Dr Mario Raviglione, Director of the WHO Stop TB Department. "In addition to specifically confronting drug-resistant TB and saving lives, programmes worldwide must immediately improve their performance in diagnosing all TB cases rapidly and treating them until cured, which is the best way to prevent the development of drug resistance."
For the first time, the global survey includes analysis of XDR-TB. However, because few countries are currently equipped to diagnose it, limited data were available for this report.
The report also points to some successes. Thirteen years ago, Estonia and Latvia were singled out by WHO as drug-resistant TB "hotspots". Following a substantial investment and a sustained assault on MDR-TB, rates in these two Baltic countries are today stabilizing and TB case notification rates are falling.
The true scale of the problem also remains unknown in some pockets of the world. Only six countries in Africa - the region with the highest incidence of TB in the world - were able to provide drug resistance data. Other countries in the region could not conduct surveys because they lack the equipment and trained personnel needed to identify drug-resistant TB. "Without these data, it is difficult to estimate the true burden and trends of MDR-TB and XDR-TB in the region. It is likely there are outbreaks of drug resistance going unnoticed and undetected," said WHO TB expert Abigail Wright, the principal author of the report.
WHO estimates that US$ 4.8 billion is needed for overall TB control in low- and middle-income countries in 2008, with US$ 1 billion for MDR-TB and XDR-TB. But there is a total finance gap of US$ 2.5 billion, including a US$ 500 million gap for MDR-TB and XDR-TB.
"The threat created by TB drug resistance demands that we fill these gaps, as laid out in the Global Plan to Stop TB, a roadmap for halving TB prevalence and deaths compared with 1990 levels by 2015," said Dr Marcos Espinal, Executive Secretary of the Stop TB Partnership. "The Plan also calls for another imperative - sufficient resources for research to find new diagnostics, new drugs effective against resistant strains and an effective TB vaccine."
For copies of the report or more information contact:
Mindfully.org note: WHO is the World Health Organization in headquartered in Geneva, Switzerland
Drug-resistant TB at highest level ever, says WHO
ALEX MELMICK /World Radio Switzerland 27feb2008
The World Health Organization in Geneva says drug-resistant tuberculosis is at its highest level ever. The WHO surveyed 81 countries and says some have reached an epidemic as death tolls from the drug-resistant strands are much higher than the commonly treatable version. There was also a significant link to drug-resistant TB and HIV. World Radio Switzerland’s Alex Helmick reports.
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Tuberculosis is a bacterial disease that affects the lungs. The WHO says as many as 18 million people have it. And 1.7 million people a year die from it.
And they fear that a more resistant strand could replace the treatable kind.
PAUL NUNN: Tuberculosis flourishes in conditions of overcrowding, poor ventilation, poor nutrition and inadequate health services.
Paul Nunn is with the WHO’s Stop TB Department. He says there is a link between poverty and TB.
NUNN: Tuberculosis is clearly present even in countries as you would describe as rich and that’s because it is an infectious disease.
The treatable kind of TB has an 85 percent survival rate. But survival rates for the two resistant strands plummet. One called MDR has a 65 percent survival rate. The other, XDR has 30 percent survival.
The irony is that the more the diseases is treated the more resistant they become, especially if treatment isn’t thorough.
NUNN: We recommend that any patient with tuberculosis is treated with at least four drugs. If a patient is not getting better, it may be they are resistant to all of those or three of those four drugs. If you add just one more drug, you’re just inviting the situation where the patient will develop additional resistance to that particular drug. And this kind of amplification of resistance goes on, and so you move from being resistant to just one drug to being resistant to several.
The disease also has ties to HIV.
HIV patients in some countries were twice as likely to have the drug-resistant form of TB as patients without HIV.
Western Europe has relatively low numbers compared to several other Eastern European and Asian blocks.But the WHO says the disease still occurs in the area and compliancy on it will result in a major International outbreak.
The organization is looking to fill a 2.5 billion dollar gap in tuberculosis funding to expand many labs and build new ones in Africa, which, the WHO says, is severely under equipped.
Alex Helmick, World Radio Switzerland at the United Nations in Geneva.
WHO reports high rates of drug-resistant TB
The Guardian (UK) 27feb2008
Drug-resistant tuberculosis is spreading faster than feared, a new report by the World Health Organisation said yesterday. There are about 500,000 new cases every year. Experts are particularly worried about the spread of XDR-TB, or extensively drug-resistant TB, a deadly strain that is virtually untreatable in poor countries. And they fear a collision between TB and the Aids pandemic may already have happened in Africa, where only six nations reported to the survey. Dr Mario Raviglione of the WHO said: "This shows what happens when you keep making mistakes in TB treatment."
Associated Press in London