Drug-resistant tuberculosis: worldwide trends, problems specific to Eastern Europe and other hotspots, and the threat...

Although it had been appreciated that high levels of antituberculous drug resistance existed in some regions of the world, the full extent of the problem was not known. A combined initiative by the World Health Organization and the International Union Against Tuberculosis and Lung Disease was launched in 1994 to address this. A second report was issued in March 2000, in which surveillance of drug resistance had been extended to 72 countries and regions. A number of drug resistant "hotspots," where there are high levels of combined multidrug-resistant tuberculosis (> 3% prevalence), have been identified. Particular areas of concern are countries of the former Soviet Union, India, and China, because these countries have the highest burden of multidrug-resistant tuberculosis. For the first time, information on trends in global drug resistance is available.