By Keith Mulvihill
NEW
YORK (Reuters Health) - Tuberculosis (TB) that is resistant to antibiotic drugs
continues to be a serious problem worldwide, according to the World Health Organization's
(WHO) latest report.
Regions with the most worrisome rates of multidrug-resistant
tuberculosis are Estonia, Latvia, Russia and China's Henan Province. Countries
where resistance to at least one drug is increasing include Denmark and Germany.
Multidrug
resistance is cause for the most concern because doctors fear that they will not
be able to treat tuberculosis at all in patients infected with resistant strains.
The
report from the WHO and the International Union against Tuberculosis and Lung
Disease is published in the April 26th issue of The New England Journal of Medicine.
"For
the first time, it is shown that multidrug-resistant tuberculosis is not only
a problem in Eastern Europe, but also in areas of Asia (such as) some provinces
in China and Iran," said lead author Dr. Marcos A. Espinal of the WHO in Geneva,
Switzerland, in an interview with Reuters Health.
"Trends also shows that
countries implementing a sound TB control strategy have not observed an increase
in multidrug-resistant tuberculosis," he added.
The massive study collected
patient information from 58 geographic sites on six continents. The international
team tested more than 60,000 TB patients.
"Among new cases of tuberculosis,
the prevalence of resistance to at least one drug ranged from 1.7% in Uruguay
to 37% in Estonia," Espinal and colleagues write.
The team reports that
multidrug resistance to tuberculosis was also high in Henan Province, China (11%);
Latvia (9%); the Russian oblasts of Ivanovo (9%) and Tomsk (7%); Iran (5%) and
China's Zhejiang Province (5%).
The findings also highlight the importance
of developing new drugs for tuberculosis.
"So far no new drugs for TB have
been developed in the last 20 to 30 years. This is a wake-up call to the industry
to boost efforts to develop new tuberculosis drugs," Espinal said.
He points
out that the current priority in fighting tuberculosis is worldwide expansion
of a technique called directly observed therapies (DOTS), in which a healthcare
worker makes certain that a TB patient takes the prescribed medicine for the required
period of time. This has been found to be the most effective method of treatment.
"DOTS
prevents drug resistance. This strategy has been proved to be highly cost-effective,"
Espinal notes.
As far as the general public is concerned, Espinal stresses
the need for "awareness, advocacy, and creation of local movements to push governments
to increase funding and political will to fight tuberculosis."
"(The) general
public should be part of the global movement, since people (have) the right to
good health," Espinal told Reuters Health.
SOURCE: The New England Journal
of Medicine 2001;344:1294-1303. |
