Drug Resistance Hampers Fight Against Tuberculosis

The growth in the rate of multidrug-resistant TB is threatening progress in the global TB fight, experts said Friday.

The spread of MDR TB continues to be a concern in Europe, according to a new report by the World Health Organization and the European Center for Disease Prevention and Control. Reported TB rates overall have been declining in Europe since 2005, standing at a regional average of 36.8 notifications per 100,000 population in 2009, according to WHO-ECDC. However, newly diagnosed and relapsed TB cases in 18 high-priority countries in the region are nearly eight times higher than the rest of Europe. Most of the high-priority nations are neither members of the European Union nor part of the European Economic Area, WHO-ECDC said.

"Vulnerable populations, including children, still do not have ready access to quality and timely diagnosis and treatment," said WHO-ECDC. "This remains a matter of urgency given the high prevalence of multi- and extensively drug-resistant TB in the region."

"Increasing rates of drug-resistant TB in Eastern Europe, Asia, and sub-Saharan Africa now threaten to undermine the gains made by worldwide TB control programs," researchers said in a separate new report in the Lancet. TB kills 1.7 million people globally each year, and the more than 9 million new cases annually is a historical high, said Alimuddin Zumla of the University College London Medical School and Stephen Lawn of the University of Cape Town.

Experts cite HIV/AIDS, rising global rates of diabetes, and high rates of smoking in low- and middle-income countries as key drivers of TB. Diabetes raises the risk of TB three-fold, and smoking increases it two-fold, the Lancet authors reported. Global TB control is being hindered by the lack of cheap and quick diagnostics, long treatment regimens, absence of an effective vaccine, rising MDR TB rates, and weak health systems, they said.

To read the WHO-ECDC report, visit: http://ecdc.europa.eu/en/publications/Publications/1103_TB_SUR_2009.pdf. The Lancet report, "Tuberculosis," was published online ahead of the print edition (2011; doi:10.1016/S0140-6736(10)62173-3).

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