Drug-resistant TB spreads in Europe3rd May 2011
Multidrug resistant tuberculosis (MDR-TB) is threatening to turn back the clock on the medical profession and reverse the advances made against the disease during the age of antibiotics.
According to estimates by the World Heath Organisation (WHO), one in three people globally is infected with Mycobacterium tuberculosis.
The disease killed almost one million people around the world in the course of 2009, with nearly nine million fresh cases reported the same year.
The development of antibiotics and the discovery of the BCG vaccine in the 1950s made substantial inroads against the disease.
An estimated 41 million people were cured of TB between 1995 and 2009, with an estimated 6 million deaths prevented.
But a new strain of the disease, known as MDR-TB, has shown resistance to the strongest front-line antiobiotics, rifampicin and isoniazid.
The strain has already ripped through populations in developing countries in Africa.
But a recent report published by WHO and the European Centre for Disease Prevention and Control shows the drug-resistant strain of TB to be on the rise in Europe, too.
The report was released to coincide with World Tuberculosis Day on March 24.
Summarised by Talha Burki in The Lancet Infectious Diseases, the report details an alarmingly high number of European patients with MDR-TB.
In 2009, the total number of cases had reached 27,765 in Europe alone.
Meanwhile, WHO estimates that around 5 million developed MDR-TB worldwide, although officially confirmed cases only number 440,000.
The discrepancy between estimated numbers and confirmed cases is the fault of faulty diagnostic methods for resistant strains of TB.
Only 1% of patients thought to have developed MDR-TB have access to treatment for the disease, which is believed to have killed 1·5 million people in 2009.
It is difficult and expensive to treat MDR-TB, and treatment involves taking fairly toxic drugs for a considerable period of time.
Patterns of antibiotic resistance vary from case to case, meaning that each treatment plan must be tailored to the individual.
Because TB patients are typically among the poorest in the world, pharmaceutical companies have so far not been attracted to the market for new drugs against tuberculosis.
An editorial in The Lancet called for treatment to be managed globally, as MDR-TB is not confined to certain regions.
It said immediate action was needed to improve diagnostic tools, noting that at least seven new compounds were under clinical development as treatments for the disease.
Further debate was also needed about whether or not new TB drugs should be made available to patients with non-resistant forms of TB, it said.
New drugs incorporated swiftly into front-line treatment programmes for non-resistant TB might soon become useless in the treatment of drug-resistant forms of TB, for example.
One intitiative, titled More medicine for tuberculosis (MM4TB), has as its mission the validation of at least five new drug targets and the discovery of at least one new candidate drug for trials.
The spread of MDR-TB in Europe could also induce companies to develop drugs for sale in richer countries and benefit the environment for development.
But The Lancet warned: "MDR tuberculosis will retain its hold on Europe if the epidemic is not brought under control worldwide."
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Wednesday 4th May 2011 @ 9:34
Many MDR TB patients in Myanmar are still waiting to get proper treatment with these old and expensive but effective drugs.
Hope R and D will be taken for better drugs and treatment for MDR TB in developing world.
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