27 February 2008

Drug-resistant TB at record high

Drug-resistant strains of tuberculosis have been recorded at their highest rates ever around the globe, amid shortages in funding needed to combat the disease, the WHO announced.

Drug-resistant strains of tuberculosis have been recorded at their highest rates ever around the globe, amid shortages in funding needed to combat the disease, the World Health Organisation said Tuesday.

Nearly a half million new cases of multi-drug resistant tuberculosis (MDR-TB) occur each year worldwide, or around five percent of the total nine million new cases, the WHO said in a report. The information was based on findings collected between 2002 and 2006 on 90 000 TB patients in 81 countries.

The survey also found cases in 45 countries of extensively drug-resistant tuberculosis (XDR-TB), which is virtually untreatable. However, the authors noted that the analysis of XDR-TB was limited because few countries are equipped to diagnose it.

The bacteria that causes tuberculosis becomes drug resistant when patients fail to complete a full regimen of antibiotics. MDR-TB can take two years to treat with drugs that are 100 times more costly, while XDR-TB resists nearly all known treatments, WHO said.

Few African countries provide
In addition, the report noted that data collected in hardest-hit Africa had been limited, with only six countries on the continent able to provide drug resistance data due to lack of technology, equipment and personnel.

"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 lead author of the report.

The highest rates of drug-resistant TB were found in Baku, the capital of Azerbaijan, where "nearly a quarter of all new TB cases (22.3%) were reported as multi-drug resistant".

Other rates that surpassed levels found in the last WHO report in 2004 were found in Moldova, Donetsk in Ukraine, Tomsk Oblast in the Russian Federation and Tashkent in Uzbekistan. In sub-Saharan Africa, HIV is fuelling the spread of TB, which is in turn a major cause of death among people living with HIV.

Drug-resistant TB higher in HIV+
WHO said fatality rates are above 90 percent in HIV+ people who contract MDR-TB or XDR-TB.

According to findings in Latvia and Ukraine, researchers discovered a high incidence of drug-resistant TB among those who suffer from HIV/Aids - nearly twice the level of MDR-TB among those with HIV compared with TB patients without HIV. "Surveys in China also suggest that MDR-TB is widespread in that country," the report said.

"TB drug resistance needs a frontal assault. If countries and the international community fail to address it aggressively, we will lose this battle," said Mario Raviglione, Director of the WHO "Stop TB" department.

The WHO said around 4.8 billion dollars were necessary to fight the disease in low- and middle-income countries this year, with one billion dollars specifically set aside for resistant strains.

However, the report noted that only approximately half of that funding is currently committed. There is a "total financing gap of 2.5 billion dollars, including a 500 million dollar gap for MDR-TB and XDR-TB." – (Sapa) - February 2008

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