MDR TB at highest rate

2008-02-29 00:00

Multi-drug-resistant tuberculosis (MDR-TB) is at the highest rate ever, according to a huge global survey on drug resistant TB.

Data from South Africa shows that 996 or almost six percent of 17 615 MDR specimens collected between 2004 and October 2007 were extensively drug resistant (XDR) TB. In KwaZulu-Natal, 656 (14%) of 4 701 MDR cases recorded in this time period were XDR-TB.

The World Health Organisation (WHO) report: "Anti-Tuberculosis Drug Resistance in the World", is based on a survey of 90 000 patients in 81 countries conducted between 2002 and 2006.

The report also found a link between HIV infection and MDR-TB. In South Africa, the underlying burden of MDR-TB is high and 44% of TB patients are estimated to be co-infected with HIV.

The WHO estimated that there are nearly half a million new cases of MDR-TB — about five percent of the total nine million new TB cases — worldwide each year with more than 110 000 deaths. The highest rates were recorded in Baku, the capital of Azerbaijan, where nearly a quarter of all new TB cases were multi-drug-resistant.

"TB drug resistance needs a frontal assault. If countries and the international community fail to address it aggressively now, we will lose the battle," said Dr Mario Raviglione, director of the WHO Stop TB Department, at the release of the report in Washington on Tuesday.

"In addition to specifically confronting drug-resistant TB and saving lives, programmes world-wide 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."

The global survey for the first time included analysis of XDR-TB. XDR-TB has been recorded in 45 countries and the WHO estimates around 40 000 XDR-TB cases emerge every year.

However, few countries are equipped at present to diagnose it. South Africa is one of only two countries in Africa that can do so.

Speaking in Cape Town recently, Dr Marcos Espinal, executive secretary for the Stop TB Partnership, said Africa would not achieve the United Nations sixth Millennium Development Goal of halting and reversing the incidence of TB by 2015.

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