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Related Experiment Videos

Drug-resistant tuberculosis: laboratory issues. World Health Organization recommendations

B P Vareldzis1, J Grosset, I de Kantor

  • 1Tuberculosis Programme, World Health Organization, Geneva, Switzerland.

Tubercle and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
|February 1, 1994
PubMed
Summary
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Drug resistance in developing countries may be increasing due to underfunded tuberculosis control programs and the HIV epidemic. Resistance surveillance is key to monitoring program efficiency and guiding public health strategies.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Tuberculosis (TB) drug resistance rates in developing countries showed an initial decrease from 1962-1985.
  • Recent trends suggest a potential increase in TB drug resistance.
  • Factors influencing these trends include National Tuberculosis Control Programme (NTP) functionality and the impact of the HIV epidemic.

Purpose of the Study:

  • To analyze trends in drug resistance in developing countries.
  • To investigate the association between NTP efficiency, HIV, and drug resistance.
  • To provide recommendations for effective drug resistance surveillance.

Main Methods:

  • Review of historical data on drug resistance rates.
  • Analysis of factors potentially affecting resistance, including program resources and HIV prevalence.

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  • Discussion of methodologies for primary and acquired drug resistance surveys.

    • Main Results:

    • Well-functioning National Tuberculosis Control Programmes (NTP) were associated with decreased resistance.
    • Understaffed programs, resource limitations, and the HIV epidemic may contribute to increased resistance.
    • Resistance surveillance is a valuable indicator of NTP efficiency.

    Conclusions:

    • The HIV epidemic may compromise NTP efficiency, leading to increased drug resistance.
    • Accurate drug resistance surveys require distinguishing between HIV-positive and HIV-negative patients.
    • Defining appropriate denominators and patient cohorts is crucial for relevant resistance surveillance and program evaluation.