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Current problems of drug-resistant tuberculosis and its control
1Tuberculosis Strategy & Operations, Stop TB Department, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland. Kims@who.int
Kekkaku : [Tuberculosis]
|December 24, 2002
Summary
Drug resistance, particularly multidrug-resistant tuberculosis (MDR-TB), is a global health crisis. Addressing factors like poor treatment regimens and patient adherence is crucial to prevent its spread and protect public health.
Area of Science:
- Microbiology and Infectious Diseases
- Global Public Health
- Pharmacology and Therapeutics
Background:
- Drug resistance arises from selective pressures favoring resistant microbial mutants.
- Programmatic errors, including inappropriate regimens and non-adherence, fuel the development of drug resistance.
Discussion:
- Drug-resistant organisms spread within communities, creating secondary infections and perpetuating resistance.
- Global data reveal tuberculosis drug resistance is widespread, with significant variations between countries and patient groups.
Key Insights:
- Among previously treated patients, the median resistance to at least one major anti-TB drug is 25.2%, with a median of 8.7% for multidrug-resistant tuberculosis (MDR-TB).
- For new cases, the median resistance is 10.9% for at least one drug and 1.1% for MDR-TB, though 12 regions exceed 3% MDR-TB.
- A significant proportion of MDR-TB cases are incurable, contributing to community spread and posing a severe threat to tuberculosis control.
Outlook:
- Increased MDR-TB incidence jeopardizes future tuberculosis control efforts.
- Preventative strategies must focus on improving cure rates for new cases and rapid identification/isolation of MDR-TB patients.